| Objective:1.To investigate the status of rumination of stroke patients,and analyze the main influencing factors.2.To explore the specific content of rumination of stroke patients,the real experience in the process of rumination and the possible factors affecting rumination of patients.Methods:1.Cross-sectional survey:Using self-made patients’s general information questionnaire,Chinese Version of Event Related Rumination Inventory(C-ERRI),Activities of Daily Living(ADL),Perceived Social Support Scale(PSSS),Herth Hope Index(HHI),General Self-Efficacy Scale(GSES).The convenience sampling method was used to investigate 218 cases of stroke patients in the inpatient departments of Beijing Hospital,Xuanwu Hospital Capital Medical University,Dongzhimen Hospital Beijing University of Chinese Medicine,China-Japan Friendship Hospital,and Hospital of Traditional Chinese Medicine of Xinjiang Uygur Autonomous Region from September 2020 to February 2021,using SPSS 26.0 and SAS 9.4 statistical software for statistical analysis.The analytical methods were descriptive statistics,single factor analysis and multiple linear regression analysis.2.Semi-structured interviews:Explanatory phenomenological research method in qualitative research was used to select patients with certain differences in rumination level,age,gender,education level,disease characteristics and other aspects during the cross-sectional survey by the maximum difference sampling method,and semi-structured interviews were conducted for them.Colaizzi Phenomenology 7-step analysis and Nvivo Plus 11 software were used to analyze the original data.Results:1.Cross-sectional survey:the total score of rumination in stroke patients was the highest 59,the lowest 0,the median 20,the quartile P25 and P75 were 8 and 30,and the mean score was 20.75 ± 14.48.The average score of intrusive rumination was 9.48±8.53,and the average score of deliberate rumination was 11.28±7.91.Single factor analysis results show that with or without spouse,whether alone,whether they were the main family income source,medical treatment charge payment of intrusive rumination difference was statistically significant(P<0.05),the ability of daily life activities,social support,friend support,and other support,total score of hope level,positive attitude,the close relationship with others and stroke patients with intrusive rumination levels negatively correlated(P<0.05).Education level,whether they were the main family income source,knowledge of disease had statistical significance on the score of deliberate rumination(P<0.05),the total score of hope level,taking positive actions,intimate relationship with others were positively correlated with the level of deliberate rumination of stroke patients(P<0.05).Multiple linear regression analysis showed that the mode of medical expenses,whether it was the main source of income for the family,daily living ability and positive attitude were the influencing factors of invasive ruminant meditation in stroke patients,which accounted for 11.7%of the total variation of invasive ruminant meditation in stroke patients.Education level,knowledge of disease and active action were the influencing factors of purposive rumination in stroke patients,which accounted for 10.2%of the total variation of purposive rumination in stroke patients.2.Semi-structured interview:Through the analysis of the interview data,four themes are finally extracted.Theme 1:Negative experiences during rumination;Theme 2:Multiple factors influence the development of rumination(personal factors,disease-related factors,social factors);Theme 3:Adaptive rumination content(adaptive cognition of disease occurrence and development,positive thinking of existing problems,change of healthy attitude and behavior,plan for future life and reconstruction of life meaning);Theme 4:Nonadaptive ruminative content(traumatic memories of the occurrence and development of the disease,negative thinking of existing problems and denial of future life).Conclusion:1.The overall score of rumination in stroke patients was moderately low,and both intrusive rumination and deliberate rumination were also moderately low,suggesting that nursing staff should promote patients to improve deliberate rumination and reduce intrusive rumination.2.The main influencing factors of deliberate rumination in stroke patients include"knowledge of disease","educational level","whether it is the main source of income for the family","total score of the level of hope","positive action","intimate relationship with others".Stroke in patients with intrusive rumination of the main influence factors including"daily life activities ability" and "the medical treatment fee payment","the presence of a spouse","living way","whether it is family the main economic source","social support","friends support","other support","level the total score of hope","positive attitude" and "the close relationship with others,"factors which may interfere with the patient’s daily life activities ability,degree of understanding of the disease,social support,hope level,prompt nursing workers timely assessment of rumination of stroke patients.And focus on the lower level of culture,daily life activities ability is low,as a family the main economic source,no spouse,living alone,and at his own expense of patients pay attention to health education to patients,help patients objective to understand the knowledge of the stroke,pay attention to help patients improve self-care ability,on the premise of not affect rehabilitation treatment to reduce medical expense,to coordinate all aspects of resources to provide support for patients,and thus reduce the patient’s level of intrusive rumination,promote patients to carry out deliberate rumination,actively thinking rehabilitation plans,to solve practical problems,and realize self-reconstruction.3.Through a semi-structured interview with stroke patients,the experience of patients in the process of rumination,the specific content of rumination and the possible promoting factors of rumination of stroke patients were explored.The results showed that the contents of rumination of stroke patients were very rich and could be divided into two types:adaptive and nonadaptive.And patients with active feedback there are some possible factors that affect the rumination,this alert nurses in nursing to the patient’s emotional experience,actively communicate with patients,understand the patient’s real idea,targeted to provide help,and may promote the deliberate rumination factors shall be actively guide.4.The cross-sectional survey of this study showed that both the deliberate rumination and intrusive rumination were low in stroke patients.Through the analysis of the contrastive data,it was known that the ruminant meditation content of stroke patients could also be divided into positive and negative types,which was consistent with the cross-sectional survey results.At the same time,through the analysis of the interview data,we also preliminarily understand the possible influencing factors of rumination in stroke patients,which further supplement the results of cross-sectional influencing factors. |
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