脑卒中患者跌倒恐惧感与自我效能感及平衡能力的关系-现代医学

脑卒中患者跌倒恐惧感与自我效能感及平衡能力的关系

单位：首都医科大学附属北京康复医院中医康复中心, 北京 100144

分类号：R742

出版年·卷·期（页码）：2025·53·第十二期（1939-1945）

摘要：

目的：探究脑卒中患者跌倒恐惧感与自我效能感及平衡能力的关系。方法：选取2021年11月至2024年11月期间本院收治的脑卒中患者107例为研究对象。采用一般自我效能感量表(GSES)、简明版国际跌倒效能感量表(short FES-I)、Berg平衡量表(BBS)及一般资料调查表进行问卷调查。采用Pearson相关性分析探讨脑卒中患者跌倒恐惧感与自我效能感及平衡能力的相关性，多元线性回归分析其影响因素。结果：共回收有效问卷101份，有效回收率为94.39%。BBS评分与short FES-I评分呈显著负相关(r=-0.557, P<0.001)，GSES评分亦与short FES-I评分呈显著负相关(r=-0.505, P<0.001)。多元线性回归分析显示，年龄(β=2.286)、服药种类数(β=1.125)、使用辅助工具(β=1.604)、有跌倒史(β=1.753)、BBS评分(β=-0.412)及GSES评分(β=-0.537)均为跌倒恐惧感的独立影响因素(均P<0.05)。结论：脑卒中患者跌倒恐惧程度较高，与自我效能感及平衡能力密切相关。

Objective: To explore the relationship between fear of falling, self-efficacy, and balance ability in patients with stroke. Methods: A total of 107 patients with stroke in our hospital from November 2021 to November 2024 were selected as study subjects. Questionnaire surveys were conducted using the General Self-Efficacy Scale(GSES), Short Falls Efficacy Scale-International(short FES-I), Berg Balance Scale(BBS), and General Information Questionnaire. Pearson analysis was used to examine the correlation between fear of falling and self-efficacy and balance ability in patients with stroke. Multiple linear regression was used to analyze the influencing factors of fear of falling in patients with stroke. Results: Of the 107 participants, 101 completed valid questionnaires(effective response rate: 94.39%). The BBS score was significantly negatively correlated with the short FES-I total score(r=-0.557, P<0.001), as was the GSES score(r=-0.505, P<0.001). Multiple linear regression analysis revealed that older age(β=2.286), greater number of medications(β=1.125), use of assistive devices(β=1.604), history of falls(β=1.753), lower BBS score(β=-0.412), and lower GSES score(β=-0.537) were all independently associated with higher levels of fear of falling(all P<0.05). Conclusion: Patients with stroke have a high degree of fear of falling, which is closely related to self-efficacy and balance ability.

参考文献：

[1] 《中国卒中中心报告2020》编写组.《中国卒中中心报告2020》概要[J].中国脑血管病杂志,2021,18(11):737-743.
[2] 董芳辉,胡三莲,韦小梅,等.老年髋部骨折病人跌倒恐惧评估工具的研究进展[J].护理研究,2024,38(13):2341-2345.
[3] 眭升,厉丽,朱丽群,等.老年人跌倒恐惧的概念分析[J].护士进修杂志,2023,38(4):319-323.
[4] KIM J H,BAE S M.Association between fear of falling(fof) and all-cause mortality[J].Arch Gerontol Geriatr,2020,88:104017.
[5] 闵春燕,孙小卫,段菲,等.全髋关节置换术后患者跌倒恐惧及影响因素分析[J].护理学杂志,2021,36(23):79-81.
[6] CHIU C Y,NG M Y,LAM S C,et al.Effect of physical exercise on fear of falling in patients with stroke:a systematic review and meta-analysis[J].Clin Rehabil,2023,37(3):294-311.
[7] 夏丹玲,刘娟.基于Logistic回归与随机森林模型的老年脑梗死患者跌倒恐惧危险因素分析[J].东南大学学报(医学版),2025,44(4):654-660.
[8] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国各类主要脑血管病诊断要点2019[J].中华神经科杂志,2019,52(9):710-715.
[9] KEMPEN G I,YARDLEY L,VAN HAASTREGT J C,et al.The short FES-I:a shortened version of the falls efficacy scale-international to assess fear of falling[J].Age Ageing,2008,37(1):45-50.
[10] 邓宁,张彤,史宝欣.简明国际跌倒效能感量表在脑梗死患者中的信度和效度检验[J].中国康复理论与实践,2015,21(12):1438-1442.
[11] CHANG M C,LEE B J,JOO N Y,et al.The parameters of gait analysis related to ambulatory and balance functions in hemiplegic stroke patients:a gait analysis study[J].BMC Neurol,2021,21(1):38.
[12] 王才康,胡中锋,刘勇.一般自我效能感量表的信度和效度研究[J].应用心理学,2001,7(1):37-40.
[13] 刘梦如,梁发存,汪张毅,等.脑卒中患者跌倒恐惧变化轨迹及影响因素分析[J].护理学杂志,2022,37(23):67-71.
[14] TIAN X,MAI Y H,GUO Z J,et al.Contributing factors and interventions for fear of falling in stroke survivors:a systematic review[J].Top Stroke Rehabil,2024,31(8):772-787.
[15] SELZLER A M,HABASH R,ROBSON L,et al.Self-efficacy and health-related quality of life in chronic obstructive pulmonary disease:a meta-analysis[J].Patient Educ Couns,2020,103(4):682-692.
[16] 袁冶,范雪娇,吴涛.社会支持对早期乳腺癌患者手术方式决策冲突的影响:自我效能和积极应对的中介作用分析[J].现代医学,2025,53(5):760-766.
[17] OKOYE E C,ONWUAKAGBA I U,AKILE C C,et al.Social support,general self-efficacy,fear of falling,and physical activity among older adults in a middle-income country[J].Gerontol Geriatr Med,2022,8:23337214221097750.
[18] 宋娜,陈晓欢,陈兴泳,等.脑卒中患者跌倒恐惧的影响因素及护理对策[J].国际护理学杂志,2020,39(8):1343-1346.
[19] OH E,HONG G S,LEE S,et al.Fear of falling and its predictors among community-living older adults in Korea[J].Aging Ment Health,2017,21(4):369-378.
[20] 陈园园,刘华,霍云云,等.老年脑卒中患者跌倒恐惧状况及相关因素分析[J].中华保健医学杂志,2023,25(3):347-348,353.
[21] CHEN W C,LI Y T,TUNG T H,et al.The relationship between falling and fear of falling among community-dwelling elderly[J].Medicine(Baltimore),2021,100(26):e26492.

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