| Objectives To investigate the loneliness level and change trajectory of first-stroke patients from the acute stage to 6 months after onset,and explore the influencing factors of different change trajectories,so as to provide scientific basis for improving the physical and mental health quality of first-stroke patients.Methods In this study,351 first-stroke patients hospitalized in the Department of Neurology of two third-class hospitals in Tangshan City from October 2020 to June 2021were selected as the research objects.The general situation questionnaire,National Institute of Health Stroke Scale,Modified Rankin Scale,University of California at Los Angeles-loneliness Scale,Perceived Social Support Scale,Medical Coping Modes Questionnaire,Post-traumatic Growth Inventory,Self-rating Anxiety Scale,Mini-mental State Examination were investigated.Latent Class Growth Analysis(LCGA)was used to identify the trajectory categories of loneliness.The statistical software used includes SPSS23.0 and Mplus7.4 software package.The statistical methods are descriptive analysis,repeated measurement analysis of variance,T test,analysis of variance,Pearson correlation analysis,multiple linear regression analysis,?~2test,multi-classification logistic regression analysis,latent class growth analysis.Results 1 The loneliness of patients with first-stroke at T1～T4 four time points:mainly moderate loneliness.The loneliness scores at the four time points were(46.22±9.76),(43.17±8.48),(41.93±7.52)and(42.75±7.37)respectively.Among them,the loneliness was the heaviest in T1 period.With the progress of time,the loneliness decreased first and then increased slightly.2 Categories of loneliness trajectories in patients with first-stroke:finally,three categories of loneliness trajectories were fitted:loneliness improvement group(60.1%),loneliness plus recombination group(21.7%)and loneliness stability group(18.2%).3 Univariate analysis of loneliness trajectory of first-stroke patients:gender,marital status,personality,sleep quality,number of chronic diseases,NIHSS score,MRS score,perceived social support,confrontation score,avoidance score,submission score,post-traumatic growth,anxiety,cognitive function was related to the category of loneliness trajectory in patients with first-stroke(P<0.05).4 Multivariate analysis of loneliness trajectory of patients with first-stroke:compared with patients in the loneliness stable group,the influencing factors for the development of loneliness category into the loneliness improvement group are:marital status,the number of chronic diseases,NIHSS score,confrontation score,including patients with married(OR=5.306),one chronic disease(OR=6.985),NIHSS score<5(OR=2.707),high confrontation score(OR=1.173)were more likely to improve loneliness;Compared with the patients in the loneliness stable group,the influencing factors for the development of loneliness plus recombination include gender,MRS score,perceived social support,post-traumatic growth,anxiety and cognitive function,among patients with which women(OR=4.609),MRS score≥3(OR=3.553),low perceived social support(OR=2.773),low post-traumatic growth(OR=4.201),anxiety(OR=4.925)and cognitive impairment(OR=5.322)were more likely to suffer from increased loneliness.Conclusions 1 The loneliness level of first-stroke patients at the four time points T1～T4is at a medium level as a whole,the heaviest in T1 period,which decreases first and then increases slightly with time.2 There are heterogeneity in the development of loneliness in patients with first-stroke,showing three different change trajectories:loneliness improvement group,loneliness plus recombination group and loneliness stability group.3The influence factors of different categories of loneliness change trajectories of first-stroke patients are gender,marital status,the number of chronic diseases,NIHSS score,MRS score,perceived social support,confrontation score,post-traumatic growth,anxiety and cognitive function.Figure 4;Table 26;Reference 137... |
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