复发风险感知、社会隔离与缺血性脑卒中患者健康行为相关性及对预后的影响-现代医学

复发风险感知、社会隔离与缺血性脑卒中患者健康行为相关性及对预后的影响

单位：沧州市人民医院神经内科一区, 河北沧州 061000

分类号：R743

出版年·卷·期（页码）：2025·53·第十二期（1864-1871）

摘要：

目的：探究复发风险感知、社会隔离与缺血性脑卒中患者健康行为相关性及对预后的影响。方法：选取2022年5月至2024年3月期间本院收治的缺血性脑卒中患者120例，应用一般资料调查表、脑卒中患者复发风险感知评估量表、Lubben社会网络量表6(LSNS-6)于出院前进行调查，脑卒中健康行为量表于出院后1个月调查；出院后3个月采用改良Rankin量表(mRS)评估预后情况。Pearson相关分析复发风险感知、社会隔离与缺血性脑卒中患者健康行为关系，多元线性回归分析探讨缺血性脑卒中患者健康行为水平影响因素，并比较不同健康行为水平对患者预后的影响。结果： 120例缺血性脑卒中患者基线回收有效问卷118份，有效回收率98.33%，随访期间失访2例，最终116例研究对象完成随访。患者复发风险感知评分为(42.79±3.48)分，LSNS-6评分为(14.85±3.23)分，健康行为评分为(68.52±6.35)分，出院后3个月mRS评分0~2分者91例，3~6分者25例。患者复发风险感知、LSNS-6评分与健康行为评分及各维度分值均呈正相关(均P＜0.05)。多元线性回归分析结果显示，复发风险感知、LSNS-6评分均为缺血性脑卒中患者健康行为的影响因素(P＜0.05)。依据健康行为平均分将患者分为高、低健康行为水平组，结果显示高健康行为水平患者出院后3个月预后不良率低于低健康行为水平患者(P＜0.05)。多因素Logistic回归分析显示，健康行为评分为缺血性脑卒中患者预后不良的保护因素(P＜0.05)。结论：缺血性脑卒中患者健康行为水平与其功能预后有关，复发风险感知、社会隔离是患者健康行为水平的影响因素。优化患者风险认知，并构建社会支持网络，可能利于改善其健康行为水平和预后情况。

Objective: To investigate the associations among perceived risk of recurrence, social isolation, and health behaviors in patients with ischemic stroke, and to evaluate their impact on functional prognosis. Methods: A total of 120 patients with ischemic stroke admitted to our hospital between May 2022 and March 2024 were enrolled. Prior to discharge, participants completed the Perceived Risk of Stroke Recurrence Scale, the Lubben Social Network Scale-6(LSNS-6), and a demographic questionnaire. Health behaviors were assessed one month after discharge using the Stroke Health Behavior Scale. Functional outcomes were evaluated three months post-discharge using the modified Rankin Scale(mRS). Pearson correlation analysis was used to examine relationships between perceived recurrence risk, social isolation, and health behaviors. Multiple linear regression identified factors influencing health behavior levels, and differences in prognosis between high and low health behavior groups were compared. Results: Among 120 patients with ischemic stroke, 118 valid questionnaires were collected at baseline, with an effective questionnaire recovery rate of 98.33%. Two cases were lost follow-up after discharge, and finally 116 study subjects completed the follow-up. The recurrence risk perception score was(42.79±3.48) points, LSNS-6 score was(14.85±3.23) points, health behavior score was(68.52±6.35) points, and at 3 months after discharge, 91 cases had mRS scores of 0-2 points and 25 cases had scores of 3-6 points. Patients' recurrence risk perception and LSNS-6 scores were positively correlated with total health behavior score and scores of each dimension(P<0.05). Multiple linear regression analysis showed that recurrence risk perception score and LSNS-6 score were both influencing factors of health behaviors in patients with ischemic stroke(P<0.05). Patients were divided into high and low health behavior level groups according to the mean health behavior score. The results showed that the rate of poor prognosis at 3 months after discharge in patients with high health behavior level was lower than that in patients with low health behavior level(P<0.05). Multivariate Logistic regression analysis showed that health behavior score was a protective factor for poor prognosis in patients with ischemic stroke(P<0.05). Conclusion: Health behavior levels are significantly associated with functional prognosis in patients with ischemic stroke. Perceived risk of recurrence and social isolation are key determinants of health behaviors. Enhancing patients' risk awareness and strengthening social support networks may improve health behaviors and, consequently, clinical outcomes.

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