Study On Psychological Stress Response And Its Influencing Factors In Acute Stroke Family Caregivers

Objective:The use of mixed-method approach to understand the status of psychological stress,the actual experience of psychological stress,an d the influencing factors of family caregivers in the acute stroke,an d to analyse the relationship between stress response,social support,a nd coping styles.Providing an effective reference and basis for const ructing effective stress intervention measures for the caregiver.Methods:1.200 subjects were enrolled at 4 tertiary A-level hospitals in Gua ngzhou from March 2017 to June 2017 by using convenient sampli ng and investigated on general informatio-n questionnaire,relation str ess scale,social support scale,and simple coping style scale.200 quest ionnaires were distributed and 194 complete questionnaires were ret urned,resulting in a response rate of 97%.Excel was used to doubleentry of the questionnaire data and spss21.0 was conduct statistical analysis.2.The qualitative research method was used to conduct a semi stru ctural in-depth interview on 20 stroke family,and the data were anal yzed by the subject analysis method.Results:In this study,200 cases of stroke family caregiver were collecte d from March 2017 to June 2017 and 194 complete questionnaires were returned.1.The scores of stress for caregivers of stroke patients' family me mbers were(10.45±5.50)scores,and the overall level was low to mo derate.The standardization scores of the dimensions of caregiver stre ss response scale from high to low were the degree of disruption o f life,and the psychological pain experienced in the patient relations hip,and the degree of negative emotions experienced by the patient,t he stress response of the caregiver 1~7 days is less than 8~14 da ys(P<0.01).2.Results of multiple linear regression analysis showed that,the main influencing factors of stress response can explain 40.6% of stress factors,including the course of the disease,whether other family members need to be taken care of or not,the economic affordability,how well they master the knowledge about stroke,whether they think the patient is considered to be life-threatening or not,and total score of social support(P<0.05).3.The scores of social support for the caregivers of stroke patients' family members ranged from 32 to 55,and the total score was(44.45±5.96)scores,which was higher than the domestic norm(34.56±3.73)scores(P<0.01).Among them,there were 0 cases with low level,85 ca ses with moderate level(43.81%),and 109 cases with high level(56.19%),and the score rate from high to low was subjective support,soci al support utilization and objective support.4.The level of total stress response were negative correlated with t he level of total social support(r=-0.186,P<0.05);The level of obje ctive support dimension were negative correlated with the level of objective support dimension(r=-0.169,P<0.05);The level of total stre ss response were negative correlated with the level of objective sup port dimension(r=-0.169,P<0.05);the dimensions of psychological pa in experienced in the patient relationship were negatively correlated with subjective support,objective support,social support utilization an d total social support level(r=-0.147,r=-0.156,r=-0.149,r=-0.208,P<0.05);There are no statistical significance between the dimension of li fe being disturbed with social support and its dimensions.5.The total positive coping style score of the study population was(22.20±5.97)scores and negative coping style score was(8.43±4.27)scores indicate that this group of people mainly adopts positive cop ing styles at this stage,and Pearson correlation analysis suggests that there was no correlation between positive coping styles and stress r esponses and its each dimension,there was a significant positive cor relation between negative coping style and total stress response leve l,degree of disruption in life,psychological pain experienced in relat ion to patients,and level of negative emotions in patients(r=0.265,r=0.215,r=0.218,r=0.230,P<0.01).6.Through interviews with 20 interviewees,extracted texts were ind uctively coded using thematic synthesis,seven interrelated analytical t hemes were identified that related to acute stroke family caregiver's psychological stress experience:immense pressure and pain,lack of disease-related knowledge,heavy care tasks,diversified nursing needs,c omplicated relationship between doctors and patients,nursing tasks n eed to be improved,and national health policies need to be improved.Conclusion:1.The stress response of family caregivers in the first aid period o f stroke was generally in low to medium level,but the stress level increased gradually as the duration of the illness increased.2.The main influencing factors of the stress response are disease c ourse,whether other family members need to be taken care of,the ec onomic affordability,how well they master the knowledge about strok e,whether they think the patient is considered to be life-threatening or not,and total score of social support.3.Stroke family caregivers are in high level social support conditio n and objective support is the least.4.There is a close relationship between the stress response,social s upport,and coping styles in the family caregiver during the first-aid period,The higher level of social support,the less stress response,the more negative coping,and the higher the stress response.5.Family caregivers in the first-aid period of stroke suffer from tre mendous pain and care pressure,which is closely related to lack of knowledge about the disease,heavy care tasks,diversified nursing ne eds,complex doctor-patient relationships,tasks for nursing work to be improved,and national health policies to be improved.