Case-control Study Of Influential Factors Of Acute Stress Disorder In Patients With Stroke

Objectives Analyze the influencing factors of acute stress disorder in patients with stroke,and to provide the theoretical basis for the development of early nursing intervention.Methods The patients with stroke as the object were selected from October 2016 to September 2017 in North China University of Science and Technology of Internal Medicine-Neurology and neurosurgery in this study.The patients were randomly selected from the Stanford Acute Stress Response Questionnaire(SASRQ)to select the case group after the on set of the disease,the acute stress response of the patients with stroke was to screened out the acute stress disorder group(n=142)and the non-acute stress disorder group(n=276).The self-designed social demographic data,Activities of Daily living scale,Chinese Clinical Neurological Defect scale,Hospital Anxiety and Depression,Social Support Rate Scale,APGAP Index,Social Support Scale and Pain Visual Analog Scale and were used to evaluate the general demographic data,daily life ability,anxiety and depression,treatment,cardiac function,the degree of pain,the degree of sleep,the situation of sleep,the status of stroke social support of stroke,and to compare the differences of disease status,treatment status,pain degree,sleep condition and stroke social support status between the two groups.2 All the data were using Excel software to establish the database and the SPSS22.0 statistical software was used to analyze the data.Descriptive statistical analysis was used to analysis the general demographic data;binary logistic regression analysis was used in the univariate analysis;and multivariate analysis was performed using binary logistic regression analysis.Results 1 The univariate analysis of ASD in patients with stroke shows: age,education level,marital status,personality,income,type of medical insurance,payment of medical expenses,limb movement disorder or not,central facial paralysis or not,barylalia or not,numbness or not,dizziness,headache,basal ganglia lesion and cerebral artery vascular lesions and departmental environment affect sleep,pain affect sleep,drug assisted sleep,the ability of daily life,the degree of neurological deficits,anxiety and depression or not,the difference was statistically significant(P<0.05).2 Multivariate logistic regression analysis showed that the factors of ASD in patients with stroke is family dysfunction,anxious,pain affect sleep,dizzy,female,numbness of limbs,mild defect of nerve function,dyskinesia,hemorrhagic stroke,introvert,conservative treatment.Family dysfunction(OR=73.904,95%CI:16.770~325.691),anxious(OR=52.178,95%CI: 4.957~549.213),pain affect sleep(OR=34.469,95%CI: 8.523~139.393),dizzy(OR=19.403,95%CI: 5.785~65.074),female(OR=6.435,95%CI: 2.928~14.142),numbness of limbs(OR=5.116,95%CI: 2.060~12.70),mild defect of nerve function(OR=4.016,95%CI: 1.774~9.091),dyskinesia(OR=3.923,95%CI: 1.832~8.400),hemorrhagic stroke(OR=3.397,95%CI: 1.003~11.511),introvert(OR=3.115,95%CI: 1.179~8.227)are the risk factors for acute stress disorder in patients with stroke.Conservative treatment(OR=0.130,95%CI:0.037~0.459)are the protective factors of acute stress disorder in patients with stroke.Conclusions The incidence of acute stress disorder in patients with stroke is related to the family dysfunction,anxious,pain affect sleep,dizzy,female,numbness of limbs,mild defect of nerve function,dyskinesia,hemorrhagic stroke,introvert and conservative treatment.Family dysfunction,anxious,pain affect sleep,dizzy,female,numbness of limbs,mild defect of nerve function,dyskinesia,hemorrhagic stroke,introvert are the risk factors for acute stress disorder in patients with stroke.Conservative treatment is the protective factors of acute stress disorder in patients with stroke.