Abstract:

Objective To describe the level of care dependency among elderly stroke patients and to explore the influencing factors.Methods From April 2017 to November 2017,totally 262 elderly stroke patients in the neurology ward and general medicine ward of a tertiary hospital in Beijing were selected. A self-designed general information questionnaire was used to collect patients’ demographic data and disease related data. Care Dependency Scale,Mini-Mental State Examination,Mini Nutritional Assessment-short form and Geriatric Depression Scale were used to measure care dependency and influencing factors. Binary logistic regression analysis was used to investigate the influencing factors.Results Among 262 elderly stroke patients,the score of care dependency was （56.04± 10.531）,the incidence of care dependency was 80.5%. Multivariate regression analysis showed that：age,history of fall within one year,limb dysfunction,number of chronic diseases,depression,nutritional status and cognitive function state were the influencing factors（P<0.05）.Conclusion The incidence of care dependency in elderly stroke patients was high,which was related to age,history of fall,limb dysfunction,comorbidity,depression status,abnormal nutritional status and cognitive function. It suggests that nurses should take active and effective measures to reduce quality of life decreasing due to care dependency.

Key words: Aged, Stroke, Care Dependency, Root Cause Analysis

摘要：

【目的】调查老年脑卒中患者护理依赖的发生现状并分析其影响因素。【方法】采取便利抽样法,于2017年4月-11月选取北京市某三级甲等医院神经内科病房、综合科病房的老年脑卒中患者共262例,采用自行设计的一般资料调查表收集患者的人口学资料和疾病相关资料,采用护理依赖量表、简易智能精神状态检查量表、微营养评定法简表、老年抑郁量表测量老年脑卒中患者的护理依赖程度及相关因素。采用二分类Logistic回归方程探讨影响老年脑卒中患者护理依赖的因素。【结果】调查对象的护理依赖评分为（56.04±10.53）分,护理依赖的发生率为80.5%;多因素回归分析结果显示,年龄、最近1年有无跌倒史、是否留有肢体功能障碍、患慢性疾病数量、抑郁状态、营养状态及有无认知功能障碍是老年脑卒中患者护理依赖的影响因素（P<0.05）。【结论】老年脑卒中患者护理依赖的发生率高,护士在临床护理过程中应重点关注高龄、有跌倒史、留有肢体功能障碍、共病状态、抑郁状态、营养状态异常及有认知功能障碍的患者,并采取积极有效的干预措施,减少因护理依赖导致的患者生活质量下降。

关键词: 老年人, 脑卒中, 护理依赖, 影响因素分析