基于结构方程模型的脑卒中患者主要照护者智谋及其影响因素研究

Research of resourcefulness of main caregivers of stroke patients based on structural equation model and its influencing factors

  • 摘要:
    目的  分析脑卒中患者主要照护者的智谋现状,基于结构方程模型分析智谋及其影响因素间的作用路径与机制。
    方法  采用便利抽样法选取在银川市3所三级甲等医院神经内科住院的脑卒中患者的主要照护者作为研究对象,最终共纳入308例主要照护者。收集主要照护者的一般人口学资料和智谋量表、中文版知觉压力量表、疲劳量表评估结果,通过主成分分析法提取潜变量,采用AMOS 24.0软件构建脑卒中患者主要照护者智谋影响因素的结构方程模型。
    结果  脑卒中患者主要照护者的知觉压力得分为(24.98±6.36)分,疲劳得分为(5.31±2.86)分,智谋得分为(83.98±12.85)分; 相关性分析结果显示,知觉压力得分与智谋得分呈负相关(r=-0.313, P < 0.01), 疲劳得分与智谋得分呈负相关(r=-0.305, P < 0.01), 知觉压力得分与疲劳得分呈正相关(r=0.261, P < 0.01)。脑卒中患者主要照护者智谋影响因素的结构方程模型拟合较好,知觉压力对智谋具有最强的直接负向效应(β=-0.33, P < 0.05), 疲劳对智谋具有直接负向效应(β=-0.28, P < 0.05), 并通过知觉压力和社会文化因子中的文化程度和职业产生间接效应,社会文化因子对智谋有直接正向效应(β=0.27, P < 0.05)。
    结论  脑卒中患者主要照护者的智谋处于中等水平,且受知觉压力、疲劳、职业和文化程度的影响。医护人员应及时评估脑卒中患者主要照护者的知觉压力、疲劳、职业和文化程度,提供多元化的健康宣教途径和个性化的精神支持与物质支持,以减轻主要照护者压力,缓解其疲劳,提高其智谋水平,促进其身心健康。

     

    Abstract:
    Objective  To investigate the current situation of resourcefulness among the main caregivers of stroke patients, and to analyze its action pathway and influencing mechanism by using Structural Equation Model.
    Methods  Convenience sampling method was adopted to select the main caregivers of stroke patients hospitalized in the department of neurology of three hospitals with grade Ⅲ level A in Yinchuan City as the research objects, and a total of 308 main caregivers were finally included. The general demographic information, results of Resourcefulness Scale, Chinese version of the Stress Perception Scale and Fatigue Scale were collected. The latent variables were extracted by the principal component analysis. AMOS 24.0 software was used to construct a structural equation model for influencing factors of the intelligence of main caregivers of stroke patients.
    Results  The scores of perceived stress, fatigue and resourcefulness of the main caregivers of stroke patients were (24.98±6.36), (5.31±2.86) and (83.98±12.85), respectively. Correlation analysis showed that perceived stress score was negatively correlated with intelligence score (r=-0.313, P < 0.01), fatigue score was negatively correlated with intelligence score (r=-0.305, P < 0.01), perceived stress score was positively correlated with fatigue score (r=0.261, P < 0.01). The structural equation model of influencing factors on the wisdom of the main caregivers of stroke patients was well fitted. Perceived stress had the strongest direct negative effect on resourcefulness (β=-0.33, P < 0.05). Fatigue had a direct negative effect on resourcefulness (β=-0.28, P < 0.05), and had an indirect effect through perceived stress and education level and occupation in social and cultural factors. Social and cultural factors had direct positive effects on resourcefulness (β=0.27, P < 0.05).
    Conclusion  The resourcefulness of the main caregivers of stroke patients is at a medium level, which is affected by perceived stress, fatigue, occupation and education level. Medical staff should assess primary caregivers of patients with cerebral apoplexy in perceived stress, fatigue, professional and cultural level, provide diversified health education ways and the individuation of spiritual and material support so as to relieve the caregiver stress and fatigue, improve the level of primary caregivers of patients with cerebral apoplexy obtain guidance, and promote their physical and mental health.

     

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