脑卒中患者进食困难的患病情况及家属照顾负荷的现状

发布时间：2018-03-30 00:32

本文选题：脑卒中　切入点：进食困难　出处：《中国老年学杂志》2017年07期

【摘要】：目的探讨脑卒中患者进食困难的发病情况及其家属照顾负荷的影响因素。方法选取2013年1月至2016年6月该院神经内科住院的脑卒中患者,采用o%田氏饮水试验评估研究对象的进食困难情况,自行编制的进食障碍调查问卷对评估研究对象的进食障碍情况;并评估神经功能损伤情况、日常生活活动能力、认知情况。通过照顾者压力指标(CSI)对家属照顾负荷情况进行调查,采用多元线性回归方法分析影响照顾负荷的影响因素。结果脑卒中患者进食困难发生率为30.51%,入院治疗后2 w进食困难发生率为17.09%;双侧脑半球多发及延髓部位脑卒中患者进食困难发生率高,有脑卒中病史的研究对象进食困难的发生明显高于初次脑卒中者,饮食困难患者进食障碍评分明显高于正常脑卒中者(均P0.05)。家属照顾者身体负荷评分为(7.8±5.1)分,心理负荷评分为(12.6±6.7)分,社会功能负荷评分为(11.6±5.9)分,总负荷评分为(32.3±16.2)分。单因素分析发现,照顾者自身因素中,照顾者与患者关系、工作状态、自觉身体状况、照顾时间、Hamilton抑郁量表(HDRS)评分、Hamilton焦虑量表(HARS)评分对照顾者负荷得分有影响(P0.05),而患者自身因素中,患者医疗付费、病程、美国国立卫生院脑卒中评分量表(NIHSS)评分、巴氏指数(BI)评分、简明精神状况检查表(MMSE)评分等因素影响照顾者负荷得分(均P0.05);多元线性回归分析发现,照顾者自觉身体状况、照顾时间、HDRS评分、HARS评分、BI评分、MMSE评分等因素影响家属照顾者照顾负荷。结论脑卒中后进食困难发生率较高,其家属照顾负荷较大,与照顾者自身抑郁、焦虑及患者病程、日常生活活动能力、认知水平等因素有关。
[Abstract]:Objective to explore the factors influencing the incidence of stroke patients and their families to take care of dysphagia load. Methods patients with stroke in Department of Neurology in our hospital from January 2013 to June 2016, using o% test and evaluation of drinking water difficulty eating situation of object of study, to the preparation of the questionnaire on eating disorders evaluated and eating disorders; evaluation of nerve function injury, cognitive activities of daily life. The caregiver strain index (CSI) of the family caregiver burden to investigate the situation, influencing factors by multivariate linear regression analysis of influence of care burden of stroke patients with dysphagia. Results the incidence rate of 30.51%, at 2 W after treatment the incidence of dysphagia 17.09% patients with bilateral cerebral hemisphere; multiple stroke dysphagia and medullary parts of the high incidence of research object, history of stroke. There was obviously higher than the first stroke food is difficult, the difficulty of the diet was significantly higher than that of normal eating disorders in patients with stroke (P0.05). Family caregiver physical load score was (7.8 + 5.1), mental workload score (12.6 + 6.7), social function scores for load (11.6 + 5.9) points the total load, score (32.3 + 16.2). Univariate analysis showed that caregivers of their own factors, take care of the relationship, and patients work status, health conscious, care time, Hamilton Depression Scale (HDRS) score, Hamilton Anxiety Scale (HARS) score favorers score (impact load P0.05), their own factors and patients, with medical payment, the course, the U.S. National Institutes of Health Stroke Scale (NIHSS) scores, Barthel Index (BI) score, the mini mental state examination (MMSE) score and other factors affect caregiver burden score (P0.05); multiple linear regression Analysis found that caregivers' perceived health care time, HDRS score, HARS score, BI score, MMSE score and other factors of family caregivers to take care of the load. Conclusion there is a high incidence of dysphagia after stroke, the family care and take care of their own load, depression, anxiety and disease course, daily life activities. The relevant factors of cognitive level.

【作者单位】：河北医科大学第二医院神经内科;
【分类号】：R473.74

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