Abstract:

Objective To explore the time-varying characteristics and correlation degree of autonomous rehabilitation behavior and related symptoms of middle-aged stroke patients，and to provide a basis for clinical transitional nursing and precise rehabilitation. Methods Ecological momentary assessment was used to select 57 middle-aged stroke patients who underwent rehabilitation treatment in the Rehabilitation Medicine Department of a tertiary comprehensive hospital in Wuhan from March 15 to August 30，2024，using convenience sampling method. Their autonomous rehabilitation behavior and related symptoms（fatigue，pain，emotion，sensation） were continuously monitored for 2 weeks. A hierarchical linear model was used to analyze the correlation between behavior and symptoms. Results The autonomous rehabilitation behavior of middle-aged stroke patients showed a fluctuating increasing trend， and the symptom score showed a slow decreasing trend. The hierarchical linear model showed that compared with female patients，male patients have longer duration of autonomous rehabilitation behavior（P<0.05）. The number and duration of autonomous rehabilitation behaviors in patients without fatigue were higher（P<0.05）. The number of autonomous rehabilitation behaviors in patients without pain was higher than that in patients with pain（P<0.05）. The number of autonomous rehabilitation behavior items among patients who perceived more pleasure in rehabilitation was higher than that among patients with greater difficulty in rehabilitation challenges（P<0.05）. Patients with high rehabilitation confidence have higher numbers and duration of autonomous rehabilitation behaviors compared to patients with low rehabilitation confidence（P<0.05）. Conclusion There are significant individual differences and dynamic changes in the autonomous rehabilitation behavior and related symptoms of middle-aged stroke patients. Nursing staff should accurately implement personalized rehabilitation services during the transition period，enhance patients’ autonomy and self-management ability in home-based rehabilitation，in order to improve the overall rehabilitation effect.

Key words: Middle-Aged, Stroke, Autonomous Rehabilitation Behavior, Symptoms, Ecological Momentary Assessment, Nursing Care

摘要：

目的 探究中年脑卒中患者自主康复行为及相关症状的时变特性及关联度，为临床过渡期护理及精准康复提供依据。 方法 运用生态瞬时评估法，通过便利抽样法于2024年3月15日—8月30日选取武汉市某三级甲等综合医院康复医学科进行康复治疗的57例中年脑卒中患者作为调查对象，对其自主康复行为及相关症状（疲劳、疼痛、情绪、感受）进行为期2周的持续动态监测，采用多层线性模型分析行为与症状间的关联度。 结果 中年脑卒中患者自主康复行为整体呈波动增长趋势，症状评分呈缓慢下降趋势。多层线性模型显示：与女性患者相比，男性患者的自主康复行为持续时长更长（P<0.05）；无疲劳的患者自主康复行为项目数更多及持续时长更长（P<0.05）；无疼痛的患者自主康复行为项目数高于疼痛患者（P<0.05）；感受康复愉悦收获多的患者自主康复行为项目数高于康复挑战难度大的患者（P<0.05）；康复信心高的患者，其自主康复行为项目数及持续时长均高于康复信心低的患者（P<0.05）。 结论 中年脑卒中患者的自主康复行为与相关症状存在个体差异及动态变化，护理人员应精准实施过渡期个性化康复服务，增强患者居家康复的自主性和自我管理能力，以期提升整体康复效果。

关键词: 中年, 脑卒中, 自主康复行为, 症状, 生态瞬时评估, 护理