Abstract:

Objective To explore the internal correlation mechanism among symptoms and influencing factors in first-ever subacute stroke patients. Methods A cross-sectional survey method was employed to conveniently select stroke patients hospitalized in a tertiary hospital in Guangdong Province from October 2022 to June 2023. Data were collected using a general information questionnaire，Symptom Experience Scale for Stroke Survivors，Fear of Progression Questionnaire-Short Form，Acceptance of Illness Scale，Herth Hope Index，and the Memorial University of Newfoundland Scale of Happiness. Results A total of 316 stroke patients were included. The incidence of symptom burden ranged from 17.41% to 87.97%，with the core，bridge，and sentinel symptoms as decreased attention and restricted limb movements，restricted limb movements and decreased self-care ability，and limb weakness and delayed response，respectively. Age，stroke type，disease stage，self-care ability，fear of disease progression，hope level，and happiness level were predictive factors for symptom burden in patients. Mixed network analysis showed direct correlation between foot inversion and stroke type，fear of disease progression was directly associated with limb weakness and limb pain. Low mood was directly correlated with hope level and happiness level. Conclusion Symptoms in patients with first-episode subacute stroke are interrelated. Nurses should pay attention to the identification of core，bridge，and sentinel symptoms，understand the associations between symptoms and influencing factors，and provide comprehensive and personalized clinical symptom management strategies for patients.

Key words: Stroke, Symptom Burden, Root Cause Analysis, Network Analysis, Nursing Care

摘要：

目的 探索首发脑卒中恢复期患者症状间及症状与影响因素间的内部关联机制。方法 采用横断面调查法，便利选取2022年10月—2023年6月在广东省某三级甲等综合医院住院的320例首发脑卒中恢复期患者为调查对象，采用一般资料调查表、脑卒中症状体验量表、恐惧疾病进展简化量表、疾病接受度量表、Herth希望指数量表和纽芬兰纪念大学幸福度量表进行调查。 结果 共纳入脑卒中患者316例。症状负担发生率为17.41%~87.97%，其核心症状、桥梁症状和前哨症状分别为注意力下降和肢体活动受限、肢体活动受限和自理能力下降、肢体无力和反应变慢。年龄、脑卒中类型、疾病分期、生活自理能力、恐惧疾病进展、希望水平、幸福水平是患者症状负担的预测因素。混合网络分析结果显示，足内翻与脑卒中类型直接关联，恐惧疾病进展与肢体无力、肢体疼痛直接关联，闷闷不乐与希望水平和幸福水平直接相关。 结论 首发脑卒中恢复期患者症状间相互关联。护理人员应注意对核心症状、桥梁症状和前哨症状的识别，了解症状与影响因素间的关联机制，从而为患者提供全面、个性化的临床症状管理策略提供依据。

关键词: 脑卒中, 症状负担, 影响因素分析, 网络分析, 护理