慢性疾病病耻感量表的汉化及在脑卒中患者中的应用研究

发布时间：2018-05-21 09:24

本文选题：脑卒中 + 病耻感　；参考：《天津医科大学》2017年硕士论文

【摘要】：目的1.汉化慢性疾病病耻感量表(Stigma Scale for Chronic Illness,SSCI)并检验其在脑卒中患者中的信度和效度,最终形成中文版慢性疾病病耻感量表;2.调查我国脑卒中患者病耻感水平并探讨该群体病耻感的影响因素。方法1.采用便利抽样的方法于2016年3月至2016年6月选取天津市两家社区服务中心的204名脑卒中患者为研究对象。按照量表翻译程序对慢性疾病病耻感量表进行汉化,形成中文版慢性疾病病耻感量表。通过一般资料调查表,中文版慢性疾病病耻感量表,Barthel指数量表、抑郁自评量表、SF-12量表进行问卷调查。检验中文版慢性疾病病耻感量表的心理学特征,包括信度检验、效度检验。信度使用内部一致性和重测信度进行检验,效度使用内容效度、结构效度进行检验;2.采用便利抽样的方法于2016年3月至2016年6月选取天津市两家社区服务中心的189名脑卒中患者为研究对象。采用一般资料调查表、慢性疾病病耻感量表、Barthel指数量表、抑郁自评问卷、医学应对方式量表、社会支持评定量表对脑卒中患者进行调查。采用单因素分析来比较各分类变量中不同类别指标对病耻感的差异,使用相关性分析检验各连续变量(日常生活活动、抑郁状态、社会支持、应对方式)与病耻感水平的相关系数;运用多元线性回归分析,探讨脑卒中患者病耻感水平的影响因素。结果1.慢性疾病病耻感量表的信效度检验项目分析结果显示中文版SSCI能够鉴别高分组和低分组(P0.01)。各条目得分与SSCI总分的相关系数为0.472~0.806;内在病耻感的13个条目与所属维度得分的相关系数为0.673~0.807;外在病耻感的11个条目与所属维度得分的相关系数为0.519~0.845,内在病耻感、外在病耻感得分与总量表得分的相关系数分别为0.955,0.900(P0.01);总量表的Cronbach'sα系数为0.951,内在病耻感和外在病耻感维度的Cronbach'sα系数均为0.927;总量表的重测信度为0.881,内在病耻感和外在病耻感维度的重测信度为0.927,0.797;探索性因子分析提取3个公因子,累计方差贡献率为65.586%;内容效度指数I-CVI在0.800-1.000之间,S-CVI为0.932;与抑郁、日常生活能力、SF-12心理维度及生理维度的Pearson相关系数为0.609、-0.486、-0.524、-0.462(P0.01)。2.脑卒中患者病耻感的影响因素分析脑卒中患者病耻感总分为(44.96±16.71)分,其中内在病耻感得分为(27.70±10.91)分,外在病耻感得分为(17.26±7.00)分。单因素分析结果显示,婚姻状况、职业、脑卒中类型、发病次数类型、是否存在后遗症、病程对病耻感总分差异具有统计学有意义(P0.05);连续性变量Pearson相关分析中日常生活活动能力、抑郁、主观支持、客观支持、对支持的利用程度、屈服、回避和病耻感总分的相关性具有统计学意义(P0.01);多元线性回归结果显示,抑郁、逃避、主观支持、日常生活活动能力是脑卒中患者病耻感的主要影响因素,共解释57.5%的变异量。单因素分析结果显示,职业、脑卒中类型、发病次数类型、是否存在后遗症、病程对内在病耻感得分差异具有统计学有意义(P0.05);连续性变量Pearson相关分析中日常生活活动能力、抑郁、主观支持、客观支持、对支持的利用程度、屈服、回避和内在病耻感的相关性具有统计学意义(P0.01);多元线性回归结果显示,抑郁、逃避、主观支持、日常生活活动能力、是否存在后遗症是脑卒中患者内在病耻感的主要影响因素,共解释57.8%的变异量。单因素分析结果显示,职业、脑卒中发病次数类型、是否存在后遗症、病程对外在病耻感得分差异具有统计学有意义(P0.05);连续性变量Pearson相关分析中日常生活活动能力、抑郁、主观支持、客观支持、屈服、回避和外在病耻感得分的相关性具有统计学意义(P0.01);多元线性回归结果显示,抑郁、逃避、主观支持、日常生活活动能力是脑卒中患者外在病耻感的主要影响因素,共解释41.5%的变异量。结论1.本研究将英文版SSCI汉化,在脑卒中患者中对中文版SSCI进行信效度检验,研究结果表明中文版SSCI具有较好的信度和效度,可在我国脑卒中患者中使用,为我国神经系统疾病病耻感的相关研究提供了研究工具。2.我国脑卒中患者病耻感处于中等水平,内在病耻感水平较高,外在病耻感水平较低。护理人员应重视脑卒中患者的病耻感问题,重点关注抑郁水平较高、日常生活活动能力较差及留有后遗症人群,指导其采取积极的应对策略,提高其内在支持。以病耻感的影响因素为切入点,采取针对性的干预方法来降低脑卒中患者病耻感水平,以促进身心康复,提高生活质量。
[Abstract]:Objective 1. Stigma Scale for Chronic Illness (SSCI) and test its reliability and validity in stroke patients, and finally form a Chinese version of the Chinese version of chronic disease stigma, and 2. to investigate the level of the stigma of stroke patients in China and to explore the influence factors of the discomfort of the group. Method 1. adopt a convenient sampling Methods from March 2016 to June 2016, 204 stroke patients in two community service centers in Tianjin were selected as the subjects. The Chinese version of chronic disease stigma was formed according to the scale translation procedure, and the Chinese version of the chronic disease stigma, Barthel finger, was used. The scale, the self rating depression scale and the SF-12 scale were used to investigate the psychological characteristics of the Chinese version of the chronic disease stigma scale, including reliability test, validity test, reliability using internal consistency and retest reliability test, validity use content validity and structural efficiency test; 2. a convenient sampling method was used in 2016 3. From January to June 2016, 189 stroke patients in two community service centers in Tianjin were selected as the subjects. The general data questionnaire, the chronic disease stigma scale, the Barthel index scale, the self rating depression questionnaire, the medical coping style scale, and the social support rating scale were used to investigate the stroke patients. The single factor analysis was used to compare the results. The correlation coefficient of the continuous variables (daily life, depression, social support, coping style) and the level of stigma was tested by the correlation analysis, and the factors affecting the level of stigma in the stroke patients were analyzed by multivariate linear regression analysis. Results 1. chronic diseases were found. The results of the reliability and validity test of the stigma scale showed that the Chinese version of SSCI was able to distinguish between high and low scores (P0.01). The correlation coefficient of the score of each item and the total score of SSCI was 0.472~0.806; the correlation coefficient of the 13 entries of the internal disadvantageous stigma and the scores of the subordinate dimensions was 0.673~0.807; the 11 items of the external discomfort and the scores of the subordinate dimensions were scored. The correlation coefficient was 0.519~0.845, internal discomfort, the correlation coefficient between the external discomfort and the total table score was 0.955,0.900 (P0.01), the Cronbach's alpha coefficient of the total scale was 0.951, the Cronbach's alpha coefficient of the internal disadvantageous and extrinsic stigma were all 0.927, and the retest reliability of the total scale was 0.881, the internal discomfort and external diseases. The retest reliability of the dimension of the stigma was 0.927,0.797, the exploratory factor analysis extracted 3 public factors, the cumulative variance contribution rate was 65.586%, the content validity index I-CVI was between 0.800-1.000, and S-CVI was 0.932, and the Pearson correlation coefficient of depression, daily living ability, SF-12 psychological dimension and physiological dimension was 0.609, -0.486, -0.524, -0.462 (P0.01).2. brain. The influencing factors of the stigma of stroke patients were (44.96 + 16.71) points in stroke patients, including (27.70 + 10.91) scores and (17.26 + 7) points for external discomfort. Single factor analysis showed that marital status, occupation, stroke type, frequency type, sequelae, course to disease The difference in the total score of the stigma was statistically significant (P0.05); the ability of daily living, depression, subjective support and objective support in the continuous variable Pearson correlation analysis were statistically significant (P0.01) for the use of support, yield, avoidance and the total score of the diseased stigma; multiple linear regression results showed depression, escape, and subjective support. The ability of daily living was the main factor affecting the stigma of stroke patients. A total of 57.5% variations were explained. The results of single factor analysis showed that occupation, type of stroke, the number of times of the disease, the existence of sequelae, and the statistical significance (P0.05) in the difference of the internal discomfort score (P0.05) in the continuous variable Pearson correlation analysis. The ability of daily living, depression, subjective support, objective support, the correlation of use of support, yield, avoidance, and internal discomfort were statistically significant (P0.01); multiple linear regression results showed that depression, escape, subjective support, daily living activity, and whether there were sequelae were the main causes of the internal discomfort of stroke patients. To influence factors, a total of 57.8% variations were explained. The results of single factor analysis showed that the occupation, the type of stroke incidence, the existence of sequelae, the difference in the score of the stigma in the course of the disease (P0.05); the ability of daily living, depression, subjective support, objective support, and yield, in the Pearson correlation analysis of continuous variables. The correlation between avoidance and external disease stigma was statistically significant (P0.01); multiple linear regression results showed that depression, escape, subjective support, and daily living ability were the main factors affecting the external discomfort of stroke patients. A total of 41.5% variations were explained. In the 1. studies, the English version of SSCI was sinicized in stroke patients. The Chinese version of SSCI carries out the reliability and validity test. The results show that the Chinese version of SSCI has good reliability and validity. It can be used in the stroke patients in China. It provides a research tool for the related research on the pubic sense of the disease of the nervous system in our country,.2., the level of the pubic sense of the stroke patients in China is in the middle level, the internal disgrace is high, and the external disgrace is disgraced. The sense level is low. The nursing staff should pay attention to the problem of the stigma of stroke patients, pay more attention to the high level of depression, poor daily living ability and the population with sequelae, guide them to take active coping strategies and improve their internal support. The level of stigma in stroke patients is to promote physical and mental rehabilitation and improve the quality of life.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.2

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