脑卒中患者病耻感影响因素的系统评价

doi:10.16460/j.issn1008-9969.2022.08.046

摘要/Abstract

摘要： 目的系统评价脑卒中患者病耻感水平及影响因素。方法检索The Cochrane Library、PubMed、EMBase、Scopus、Web of Science、CBM、CNKI、万方、维普等中英文数据库,时间限定为建库至2021年4月23日。纳入有关脑卒中患者病耻感水平及影响因素的观察性研究后,由2名研究人员分别进行文献筛选及数据提取,参照美国卫生保健质量和研究机构关于观察性研究的偏倚风险评价标准进行文献质量评价,并定性分析、归纳与总结纳入研究的基本情况与结果。结果共纳入21项研究,包括17项中文研究及4项英文研究,涉及年龄、日常生活活动能力、经济条件、社会支持、后遗症情况、抑郁状态等27个影响因素,总结为个人因素、环境因素及脑卒中疾病相关因素3大类。结论脑卒中患者普遍存在病耻感但水平不一致,影响脑卒中患者病耻感水平的主要因素为日常生活活动能力、经济条件、社会支持、后遗症情况及抑郁状态,次要因素为年龄、职业、婚姻状态、性格类型、应对方式（回避）、发病类型、发病次数及合并慢性病数量,其他尚存在争议的影响因素有待进一步研究验证。

关键词: 脑卒中, 病耻感, 影响因素, 系统评价

Abstract: Objective To systematically evaluate the stigma and its influencing factors in stroke patients. Methods We searched databases inlcuding The Cochrane Library, PubMed, EMBase, Scopus, Web of Science, CBM, CNKI, Wanfang Data, and VIP from the inception to April 23, 2021. After including observational studies on stigma and its influencing factors of stroke patients, two researchers conducted literature screening and data extraction respectively, and the literature quality was evaluated according to the bias risk assessment criteria of Agency for Healthcare Research and Quality. After qualitative analysis, the general information and results in the included literature were summarized. Results A total of 21 studies were included, with 17 studies in Chinese and 4 studies in English. Twenty-seven influencing factors of age, activities of daily living, economic conditions, social support, with sequelae or not, and depression were summarized into three categories: personal factors, environmental factors, and stroke-related factors. Conclusion Stroke patients generally have a sense of stigma but with inconsistent levels. The main factors affecting stigma of stroke patients are the ability of daily living, economic conditions, social support, with sequelae or not and depression, and the secondary factors are age, occupation, marital status, personality type, coping style (avoidance), and type of disease, number of incidences and number of combined chronic diseases. Other controversial influencing factors need to be further studied and verified.

Key words: stroke, stigma, influencing factor, systematic review

中图分类号:

R473.74

燕文娟, 李壮苗, 余梦婷, 李施恩, 池艳红. 脑卒中患者病耻感影响因素的系统评价[J]. 护理学报, 2022, 29(8): 46-52.

YAN Wen-juan, LI Zhuang-miao, YU Meng-ting, LI Shi-en, CHI Yan-hong. Systematic Review of Influence Factors of Stigma in Stroke Patients[J]. Journal of Nursing, 2022, 29(8): 46-52.

参考文献

[1] Erving G.Stigma:Notes on the Management of Spoiled Identity[M].Upper Saddle River:Prentice-Hall,1963.DOI:10.1136/pgmj.45.527.642.
[2] 顾鑫萍,李玲.精神分裂症病人病耻感影响因素及干预的研究进展[J].护理研究,2019,33(24):4285-4289.DOI:10.12102/j.issn.1009-6493.2019.24.019.
[3] 李利平,孙建萍,吴红霞,等. 慢性病患者病耻感的研究现状[J].解放军护理杂志,2020,37(3):75-78.DOI:10.3969/j.issn.1008-9993.2020.03.021.
[4] 于媛,刘均娥.我国患者病耻感研究现状与趋势的文献计量学分析[J].中华现代护理杂志, 2016, 22(11):1507-1510.DOI:10.3760/cma.j.issn.1674-2907.2016.11.006.
[5] 汤明文,张燕红,刘寿娟.425例住院缓解期精神分裂症患者病耻感现状及影响因素分析[J].护理学报,2019,26(14):43-47.DOI:10.16460/j.issn1008-9969.2019.14.043.
[6] 李荔,刘丽娟.基于GoPubMed对病耻感相关文献的计量学分析[J].中国心理卫生杂志,2017,31(11):857-861.DOI:10.3969/j.issn.1000-6729.2017.11.005.
[7] 国家卫生健康委员会.2018中国卫生健康统计提要[M].北京:中国协和医科大学出版社,2018.
[8] Winstein CJ, Stein J, Arena R, et al.Guidelines for Adult Stroke Rehabilitation and Recovery:A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association[J]. Stroke, 2016,47(6):e98-e169.DOI:10.1161/STR.0000000000000098.
[9] 张芳,李晓萍,曾庆枝,等.病耻感量表现状[J].医学综述,2015,21(2):286-288.DOI:10.3969/j.issn.1006-2084.2015.03.038.
[10] 唐霞珠,黄琴,朱海萍.脑卒中病人病耻感的研究进展[J].全科护理,2019, 17(17):2091-2095.DOI:10.12104/j.issn.1674-4748.2019.17.016.
[11] Dougherty DM,Shapiro GG.Agency for Healthcare Research and Quality[J].Alphascript Publishing,2001,73(29):81-83.DOI:10.3122/jabfm.2012.02.120023.
[12] 冯宇,王端.市场调查与预测分析[M].北京:北京理工大学出版社.2018.
[13] Sarfo FS,Nichols M,Qanungo S, et al.Stroke-related Stigma among West Africans:Patterns and Predictors[J]. J Neurol Sci,2017,375(17):270-274.DOI:10.1016/j.jns.2017.02.018.
[14] 张真容,闫冰,林乾冰,等.贵阳市脑卒中病人病耻感与生存质量的调查研究[J].全科护理,2018,16(8):897-899.DOI:10.3969/j.issn.1674-4748.2018.08.001.
[15] 龚青霞. 脑卒中恢复期患者病耻感与生存质量的相关性分析[D].成都:成都中医药大学,2018.
[16] 童琪,钟清玲,虞芬,等.脑卒中患者病耻感水平及其影响因素[J].中国老年学杂志,2018,38(24):6114-6116.DOI:10.3969/j.issn.1005-9202.2018.24.084.
[17] 冯琦. 脑卒中患者病耻感与应对方式、生活质量的相关性研究[D].咸阳:陕西中医药大学,2019.
[18] 万琼红,赵惠芬,杨鸿雁.脑卒中患者病耻感现状调查及其影响因素[J].神经病学与神经康复学杂志,2019,15(2):95-101.DOI:10.12022/jnnr.2019-0025.
[19] 黄朝军. 脑卒中患者病耻感及相关影响因素研究[D].延安:延安大学,2019.
[20] Zhu M,Zhou H,Zhang W, et al.Stigma Experienced by Chinese Patients with Stroke during Inpatient Rehabilitation and Its Correlated Factors:a Cross-sectional Study[J]. Top Stroke Rehabil, 2019,26(5):342-348.DOI:10.1080/10749357. 2019.1605759.
[21] Deng C,Lu Q,Yang L.et al.Factors Associated with Stigma in Community-dwelling Stroke Survivors in China:A Cross-sectional Study[J]. J Neurol Sci, 2019,407:116459.DOI:10.1016/j.jns.2019.116459.
[22] 吴志敏. 脑卒中患者生命意义感、病耻感与创伤后成长的相关性研究[D].吉林:延边大学,2019.
[23] 许微微,李丽华.青年脑卒中病人病耻感现状及影响因素分析[J].全科护理,2019,17(14):1668-1670.DOI:10.12104/j.issn.1674-4748.2019.14.002.
[24] 查梦培,李晶,刘妍,等.脑出血偏瘫患者病耻感现状与伤残接受度的相关性研究[J].中国护理管理,2020,20(3):459-463.DOI:10.3969/j.issn.1672-1756.2020.03.029.
[25] 庞丹莉. 湖南省某地区住院脑卒中患者病耻感现状及影响因素研究[D].长沙:湖南师范大学,2020.
[26] 李牧玲,王晓艳,白雪洁,等.广州市某医院脑卒中住院患者病耻感现状及其影响因素[J].医学与社会, 2020,33(4):105-108.DOI:10.13723/j.yxysh.2020.04.025.
[27] Hu R,Wang X, Liu Z, et al.Stigma,Depression,and Post-traumatic Growth among Chinese Stroke Survivors:A Longitudinal Study Examining Patterns and Correlations[J]. Top Stroke Rehabil, 2020, 12(28):1-14.DOI:10.1080/10749357.2020.1864965.
[28] 陈宏梅. 缺血性脑卒中患者卒中后疲劳与病耻感关系的研究[D].扬州:扬州大学,2020.
[29] 刘枫. 首发缺血性脑卒中患者病耻感水平及影响因素的纵向研究[D].湖州:湖州师范学院, 2020.
[30] 尚芳芳. 老年脑卒中患者家庭照护现状与病耻感相关性研究[J].中国老年保健医学,2020,18(1):139-140.DOI:10.3969/j.issn.1672-2671.2020.01.054.
[31] 王萧,马红梅,陈媛,等.社会支持在脑卒中偏瘫病人病耻感与负性情绪之间的中介效应分析[J].实用老年医学,2020,34(12):1313-1316. DOI:10.3969/j.issn.1003-9198.2020.12.028.
[32] 王亚男,刘化侠,张淑香,等.523例住院脑卒中患者自我概念与病耻感的相关性分析[J].护理学报,2020,27(21):61-63.DOI:10.16460/j.issn1008-9969.2020.21.061.
[33] 胡瑞丹,周宏珍,刘志红,等.病耻感与首发卒中患者卒中后抑郁的相关性研究[J].中国全科医学, 2021,24(6):727-731.DOI:10.12114/j.issn.1007-9572.2020.00.616.
[34] Rao D, Choi SW, Victorson D, et al.Measuring Stigma Across Neurological Conditions:The Development of the Stigma Scale for Chronic Illness(SSCI)[J].Qual Life Res,2009,18(5):585-595.DOI:10.1007/s11136-009-9475-1.
[35] Molina Y, Choi SW, David C, et al.The Stigma Scale for Chronic Illnesses 8-Item Version(SSCI-8):Development,Validation and Use Across Neurological Conditions[J].Int J Behav Med,2013,20(3):450-460.DOI:10.1007/s12529-012-9243-4.
[36] Wright FER.The Dimensionality of Stigma:a Comparison of Its Impact on the Self of Persons with HIV/AIDS and Cancer[J].J Health Soc Behav,2000,41(1):50-67.DOI:10.2307/2676360.
[37] 朱敏芳. 脑卒中患者病耻感量表的初步编制[D].广州:南方医科大学,2019.
[38] 魏海燕,成勇.卒中后抑郁的发病机制研究进展[J].神经损伤与功能重建, 2014, 9(4):335-336.DOI:10.3870/sjsscj.2014.04.018.

Metrics

Viewed

Full text

Abstract

Cited

Shared