| ObjectivesTo investigate the activities of daily living(ADL)among patients with Moyamoya disease(MMD)after revascularization,and to explore its influencing factors in order to develop post-operation rehabilitation strategies to improve their activities of daily living.MethodsThis cross-sectional study,investigated by convenience sampling,was conducted in three top-three hospitals in Jinan from January 2018 to June 2019.A total of 292 patients with MMD was surveyed.The survey contents included:General demographic information,disease-related information,Mini-mental State Examination(MMSE),Hospital Anxiety and Depression Scale(HADS),Social Support Rating Scale(SSRS),Activities of Daily Living Scale(ADL).The software SPSS 20.0 was conducted to analyze data.Statistical methods included descriptive analysis,independent sample t-test,Chi-square test and binary logistic regression.Results1.In this study 316 questionnaires were distributed,from which unqualified and invalid ones were excluded.Among the survey,292 patients with moyamoya disease were involved.With the gender balance,accounting for 50%respectively;the average age was 50.1±10.2 years old,45?59 was the main part,accounting for 47.9%;average monthly household income was less than 1,000 yuan,accounting for 38.4%;combined with cerebral infarction,hypertension They accounted for 30.1%and 32.2%respectively;those who frequently exercise take up 48.6%.2.The sink rate of ADL after vascular reconstruction in patients with moyamoya disease was 61%(178/292),and the falling rate in physical self-care ability beside instrumental activity of daily living was 25.7%(75/292)and 60.3%,respectively.3.The one-way ANOVA test results indicated that there were significant differences between the normal and declining ADL groups in gender,age,education,location,occupation,payment method,average monthly household income,cerebral infarction,diabetes,hypertension,time between onset and operation,postoperative complication and frequently exercising(P<0.05),In addition,there were also significant differences between these two groups in cognitive function,depression,anxiety and social support(P<0.001).4.Binary logistic regression stated clearly:gender,education level,location,occupation,monthly income per capita,postoperative complications,depression and cognitive function were the influencing factors of ADL in patients with moyamoya disease.Among them,female(P=0.042,OR=3.248).postoperative co! plications(P=0.043,OR=47.097)and depression(P=0.012,OR=1.506)were severe factors for ADL decline;On the contrary,who obtained education level of elementary/junior high school(P=0.005,OR=0.004)or high school and above(P=0.002,OR=0.002),who lived in rural areas(P=0.004,OR=0.004),who as mental labour(P=0.035,OR=0.094),who acquired family monthly income of more than 3,000 yuan(P=0.011,OR=0.085)and better cognitive function(P<0.001,OR=0.433)were protective factors for ADL decline.Conclusions1.In this study,the decline rate of ADL after revascularization in moyamoya disease patients was higher(61%),mainly due to the decrease in instrumental daily living activity.2.Gender,education,location,occupation,average monthly household income,postoperative complications,depression and cognitive function were the influencing factors of postoperative ADL decline among patients with moyamoya disease.The incidence of ADL decline among women,postoperative complications,and depression was higher.The incidence of ADL decline was lower among patients with higher education and average monthly household income,better cognitive function,mental work,and rural dwelling.3.In view of the above factors,medical personnel ought to identify as well as paying attention to high-risk groups of ADL decline earlier,developing beside implementing rehabilitation nursing measures to abate the incidence of postoperative ADL decline among patients with moyamoya disease,enhancing the quality of life,and preventing the occurrence of disability. |
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