Potential profiling analysis and influencing factors of apathy among stroke patients

doi:10.3761/j.issn.0254-1769.2025.13.010

Abstract

Abstract:

Objective To identify the potential categories and influencing factors of apathy in stroke patients，providing a basis for precise typing and individualized interventions by healthcare professionals. Methods Using the convenience sampling method，stroke patients from 2 tertiary hospitals in Xinjiang Uggur Automous Region were selected from November 2023 to August 2024，and were surveyed using the General Information Questionnaire，Apathy Evaluation Scale-Informant，Perceived Autonomy Scale，and Stroke Self-Efficacy Questionnaire.The latent profile analysis was used to identify potential categories of apathy，and logistic regression analysis was used to explore the differences in the characteristics of patients in different categories. Results The apathy symptoms of 521 stroke patients could be divided into 3 potential categories：mild apathy group（23.6%），moderate apathy-low interest-low behavioral group （46.5%），and heavy apathy-low interest-low cognitive group（29.9%）. Logistic regression showed that age 45~<60 years，duration of the disease <6 months，and high rehabilitation self-efficacy were the common protective factors of the moderate apathy-low interest-low behavioral group and the heavy apathy-low interest-low cognitive group.The dependence on activities of daily living was a risk factor for the moderate apathy-low interest-low behavioral group，and high perception of autonomy was a protective factor for the heavy apathy-low interest-low cognitive group. Conclusion Apathy symptoms in stroke patients are characterized by distinct categories，which are influenced by age，stroke duration，ADL，rehabilitation self-efficacy，and perception of autonomy. Healthcare professionals should adopt effective strategies to precisely intervene based on different potential categories of protective factors and risk factors to alleviate their apathy.

Key words: Stroke, Apathy, Potential Profile Analysis, Root Cause Analysis, Nursing Care

摘要：

目的识别脑卒中患者淡漠症状的潜在类别及影响因素，为医护人员精准分型及个体化干预提供依据。方法采用便利抽样法，选取2023年11月—2024年8月新疆维吾尔自治区某2所三级甲等医院的530例脑卒中患者作为调查对象，采用一般资料调查表、淡漠评定量表-知情者版、自主性感知量表、脑卒中康复自我效能量表、改良Barthel指数进行调查，采用潜在剖面分析识别淡漠症状的潜在类别，采用Logistic回归探讨脑卒中患者淡漠症状潜在剖面的影响因素。结果回收有效问卷521份，有效问卷回收率为98.3%。521例脑卒中患者的淡漠症状可分为3个潜在类别：淡漠症状较轻组（23.6%）、淡漠症状中等-低兴趣-低行为组（46.5%）、淡漠症状较重-低兴趣-低认知组（29.9%）。Lo-gistic回归显示：年龄45~<60岁、病程<6个月和高康复自我效能是淡漠症状中等-低兴趣-低行为组和淡漠症状较重-低兴趣-低认知组的共同保护因素，日常生活活动依赖是淡漠症状中等-低兴趣-低行为组的危险因素，高自主性感知是淡漠症状较重-低兴趣-低认知组的保护因素。结论脑卒中患者的淡漠症状具有明显的类别特征，医护人员应针对不同潜在类别的保护因素与危险因素，采取有效策略进行精准干预，改善其淡漠症状。

关键词: 脑卒中, 淡漠, 潜在剖面分析, 影响因素分析, 护理

LI Hua, ZHOU Jing, ZU Baifa, WU Fuchen, YAO Ensheng. Potential profiling analysis and influencing factors of apathy among stroke patients[J]. Chinese Journal of Nursing, 2025, 60(13): 1595-1602.

李华, 周静, 祖百法, 吴复琛, 姚恩生. 脑卒中患者淡漠症状的潜在剖面及影响因素研究[J]. 中华护理杂志, 2025, 60(13): 1595-1602.

Figures/Tables 4

Table 1 Potential profiles of apathy symptoms in stroke patients

Figure 1 Characteristic distribution of 3 potential profiles of apathy symptoms in stroke patients

Table 2 Univariate analysis of the potential profile of apathy symptoms in stroke patients

Table 3 Logistic regression analysis of the latent categories of apathy symptoms in stroke patients

References 23

[1]	Van Dalen JW, Moll Van Charante EP, Nederkoorn PJ, et al. Post-stroke apathy[J]. Stroke, 2013, 44(3):851-860.
[2]	Sagen-Vik U, Finset A, Moum T, et al. The longitudinal course of anxiety,depression and apathy through two years after stroke[J]. J Psychosom Res, 2022, 162:111016.
[3]	谭绍英, 林晓丽, 刘赞, 等. 重复经颅磁刺激联合认知训练对缺血性脑卒中患者淡漠的效果研究[J]. 中华护理杂志, 2023, 58(3):282-288.
	Tan SY, Lin XL, Liu Z, et al. Effects of repetitive transcranial magnetic stimulation combined with cognitive training in pa-tients with apathy after ischemic stroke[J]. Chin J Nurs, 2023, 58(3):282-288.
[4]	Zhou J, Fangma Y, Chen Z, et al. Post-stroke neuropsychiatric complications:types,pathogenesis,and therapeutic intervention[J]. Aging and Dis, 2023, 14(6):2127-2152.
[5]	Horne KS, Gibson EC, Byrne J, et al. Post-stroke apathy:a case series investigation of neuropsychological and lesion characteristics[J]. Neuropsychologia, 2022, 171:108244.
[6]	Tay J, Morris RG, Markus HS. Apathy after stroke:diagnosis,mechanisms,consequences,and treatment[J]. Int J Stroke, 2021, 16(5):510-518.
[7]	Myhre P, Radakovic R, Ford C. Validation of the self-rated Dimensional Apathy Scale in community stroke survivors[J]. J Neurol Sci, 2022, 434:120103.
[8]	中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国各类主要脑血管病诊断要点2019[J]. 中华神经科杂志, 2019, 52(9):710-715.
	Cerebrovascular Disease Group of the Neurological Branch of the Chinese Medical Association,Chinese Medical Association, Neurological Branch of the Chinese Medical Association. Diagnostic criteria of cerebrovascular diseases in China(version 2019)[J]. Chin J Contemp Neurol Neurosurg, 2019, 52(9):710-715.
[9]	李树亚, 李峥. 两种淡漠评定量表知情者版的汉化及效度信度检验[J]. 中国心理卫生杂志, 2018, 32(8):656-661.
	Li SY, Li Z. Validity and reliability of the Chinese version of the Lille Apathy Rating Scale-Informant and the Apathy Evaluation Scale-Informant[J]. Chin Ment Heal J, 2018, 32(8):656-661.
[10]	倪平, 陈京立, 刘娜. 护理研究中量性研究的样本量估计[J]. 中华护理杂志, 2010, 45(4):378-380.
	Ni P, Chen JL, Liu N. The sample size estimation hi quantitative nursing research[J]. Chin J Nurs, 2010, 45(4):378-380.
[11]	Marin RS, Biedrzycki RC, Firinciogullari S. Reliability and validity of the Apathy Evaluation Scale[J]. Psychiatry Res, 1991, 38(2):143-162.
[12]	Hertz J. The Perceived Enactment of Autonomy Scale:measur-ing the potential forself-care action in the elderly[J]. Diss Abstr Int, 1991(52):1953B.
[13]	王博. 老年患者自主性感知现状及影响因素研究[D]. 山西医科大学, 2018.
	Wang B. The level and influencing factors of perceived enactment of autonomy among elderly patients[D]. Shanxi Medical University, 2018.
[14]	Jones F, Partridge C, Reid F. The Stroke Self-Efficacy Ques-tionnaire:measuring individual confidence in functional performance after stroke[J]. J Clin Nurs, 2008, 17(7B):244-252.
[15]	李鸿艳, 方亮, 毕瑞雪, 等. 中文版脑卒中康复自我效能量表的信效度研究[J]. 中华护理杂志, 2015, 50(7):790-794.
	Li HY, Fang L, Bi RX, et al. The reliability and validity of the Chinese version of Stroke Self-Efficacy Questionnaire[J]. Chin J Nurs, 2015, 50(7):790-794.
[16]	李小峰, 陈敏. 改良Barthel指数评定量表的设计与应用[J]. 护理研究, 2015, 29(13):1657-1658.
	Li XF, Chen M. Design and application of the Modified Barthel Index Rating Scale[J]. Chin Nurs Res, 2015, 29(13):1657-1658.
[17]	温璞. 缺血性脑卒中患者急性期情感淡漠的影响因素[J]. 中国健康心理学杂志, 2019, 27(2):199-203.
	Wen P. The influencing factors of acute apathy in patients with ischemic stroke[J]. Chin J Health Psychol, 2019, 27(2):199-203.
[18]	Li H, Jacob MA, Cai M, et al. Meso-cortical pathway damage in cognition,apathy and gait in cerebral small vessel disease[J]. Brain, 2024, 147(11):3804-3816.
[19]	何福培, 林蓓蕾, 刘雪婷, 等. 缺血性脑卒中患者健康行为决策现状及其影响因素分析[J]. 中华护理杂志, 2024, 59(18):2222-2229.
	He FP, Lin BL, Liu XT, et al. Current situation of the health behavioral decision making in ischemic stroke patients and its influencing factors analysis[J]. Chin J Nurs, 2024, 59(18):2222-2229.
[20]	Quang H, McDonald S, Huynh-Le P, et al. Apathy in a high prevalence population of moderate to severe traumatic brain injury:an investigation in Vietnam[J]. Neuropsychology, 2021, 36(1):94-102.
[21]	Green SL, Gignac GE, Watson PA, et al. Apathy and depression as predictors of activities of daily living following stroke and traumatic brain injuries in adults:a meta-analysis[J]. Neu-ropsychol Rev, 2022, 32(1):51-69.
[22]	Tay J, Tuladhar AM, Hollocks MJ, et al. Apathy is associated with large-scale white matter network disruption in small vessel disease[J]. Neurology, 2019, 92(11):e1157-e1167.
[23]	王冬华, 罗艳, 周通, 等. 农村老年慢性病病人老化态度、自主性感知现状及其影响因素研究[J]. 护理研究, 2020, 34(14):2563-2566.
	Wang DH, Luo Y, Zhou T, et al. Study on attitudes to aging perception status of autonomy and influencing factors of rural elderly patients with chronic diseases[J]. Chin Nurs Res, 2020, 34(14):2563-2566.