Abstract:

Objective To construct a structural equation model to analyze the effect of various factors on the quality of life in stroke patients. Methods In this cross-sectional study, a total of 657 stroke patients from 2 tertiary A hospitals in Shanghai were enrolled as investigation subjects via convenience sampling methodology. General information questionnaire，Sense of Coherence Scale-13，Perceived Social Support Scale，Medical Coping Modes Questionnaire，National Institutes of Health Stroke Scale，Self-Esteem Scale and Stroke-Specific Quality of Life were utilized as the investigating tools；Mplus 7.4 was used to construct a structural equation model. Results The average score of quality of life in stroke patients was（178.30±30.30）；neurological status，self-esteem were negatively cor-related with quality of life（P<0.05）；sense of coherence，social support，coping style were positively correlated with quality of life（P<0.05）；sense of coherence，taking a confrontational approach for coping，yielding and neurological status had a direct impact on quality of life（path coefficients were 0.471，0.169、0.135，-0.089，P<0.05）；social sup-port，self-esteem，sense of coherence and neurological status had an indirect impact on quality of life（path coefficients were 0.232，0.108，0.058，-0.058，P<0.001）. Conclusion The quality of life in stroke patients is influenced by multi- ple factors interactively，and sense of coherence is an important factor affecting the quality of life；adopting a confron-tational approach as coping styles，good social support and high self-esteem can improve the level of quality of life.

Key words: Stroke, Quality of Life, Root Cause Analysis, Structural Equation Model, Nursing Care

摘要：

目的 构建结构方程模型，分析各影响因素对脑卒中患者生活质量的影响路径。 方法 通过横断面研究，采用便利抽样法，选取2021年3月—2022年1月上海市2所三级甲等医院门诊或病房的657例脑卒中患者作为研究对象，采用一般资料调查问卷、心理一致感量表、领悟社会支持量表、医学应对方式问卷、美国国立卫生研究院卒中量表、自尊量表和脑卒中专门化生活质量量表进行调查；应用Mplus 7.4构建结构方程模型。 结果 脑卒中患者生活质量得分为（178.30±30.30）分，神经功能状态、自尊与生活质量呈负相关（P<0.05），心理一致感、社会支持、应对方式与生活质量呈正相关（P<0.05）；心理一致感、面对、屈服、神经功能状态对生活质量有直接影响（路径系数分别为0.471、0.169、0.135、-0.089，均P<0.05），社会支持、自尊、心理一致感和神经功能状态对生活质量有间接影响（路径系数分别为0.232、0.108、0.058、-0.058，均P<0.001）。 结论 脑卒中患者的生活质量受多种因素交互影响，心理一致感是生活质量的重要影响因素；采取面对的应对方式、良好的社会支持与较高的自尊能够改善其生活质量水平。

关键词: 脑卒中, 生活质量, 影响因素分析, 结构方程模型, 护理