Status Influential Factors Of Self-management For Young Stroke Patients

ObjectiveTo describe the current situation of self-management level of young stroke patients,analyze the influencing factors of self-management of young stroke patients,and explore the correlation between self-management and self-efficacy,self-perceived burden and social support level.The purpose of this study is to arouse the attention of medical staff on Self-management Assessment of young stroke patients,to provide reference for further intervention research,change the health behavior of patients,formulate individualized holistic nursing intervention,and to provide reference for preventing recurrence of stroke,reducing physical disability,reducing medical care costs and economic burden,and improving the quality of life of patients.MethodsUsing convenience sampling method,from August 2017 to October 2018,young stroke patients in cerebrovascular disease areas,neurology,emergency medicine and neurorehabilitation departments of a hospital in Henan Province were selected as the subjects of investigation.General information questionnaire,self-management behavior scale for young stroke patients,chronic disease self-efficacy scale(SSC),self-perceived burden scale(SPBS),social support rating scale(SSRS)were used to investigate young stroke patients.Epidata 3.1 software was used to establish the database,and SPSS 22.0 software was used to carry out statistical analysis of data.In statistical description,the mean and standard deviation were used to measure the data,and the frequency and percentage were used to represent the counting data.Independent sample t-test and one-way ANOVA were used to compare the data between groups.Pearson correlation analysis was used to explore the correlation.Multivariate linear regression analysis was used for multivariate analysis.ResultsA total of 286 questionnaires were distributed in this study.249 valid questionnaires were collected,with an effective recovery rate of 87.06%.2 The total score of self-management of young stroke patients was(67.88+19.26).The five dimensions of self-management were:symptom management(25.39+7.05),emotional management(9.90+2.52),rehabilitation exercise management(9.58+4.02),daily life management(16.15+6.13)and resource utilization management(6.85+3.18).The total score of self-efficacy of young stroke patients was(6.42+1.62),which was in the middle level.Among them,0.4%patients had low level of self-efficacy,69.9%patients had medium level of self-efficacy,and 29.7%patients had high level of self-efficacy.Most young stroke patients'self-efficacy is in the middle level.4.The total score of self-perceived burden of young stroke patients was(31.02+6.53),which was at a moderate level.Among them,2%had no obvious burden,24.5%had mild self-feeling burden,57.0%had moderate self-feeling burden,16.5%had severe self-feeling burden,young stroke patients had higher self-feeling burden,and most of them had moderate and moderate self-feeling burden.The total score of social support of young stroke patients was(41.02+4.52).74.7%of them had a middle score of social support and 25.3%had a high score of social support.The results of single factor analysis showed that there were significant differences in self-management scores among young stroke patients with different educational background,marital status,family income per capita,the number of complications and activities of daily living(P<0.05).Relevant analysis showed that self-efficacy and social support were positively correlated with self-management,while self-perceived burden was negatively correlated with self-management.Multiple linear regression analysis showed that the marital status,educational level,family income per capita,the number of complications,activities of daily living,self-efficacy,self-perceived burden and social support of young stroke patients were.The influencing factors of self-management in young stroke patients explained 65.2%variation of self-management(F=58.991,R~2=0.663,adjusted R~2=0.652).Conclusions1.The self-management level of young stroke patients is low,which needs further improvement.2.There are many factors affecting self-management,including marital status,educational level,monthly family income,the number of complications,activities of daily life,self-efficacy,self-perceived burden,social support and so on.3.The level of self-efficacy is positively correlated with the level of self-management;the level of social support is positively correlated with the level of self-management;and the level of self-perceived burden is negatively correlated with the level of self-management.Medical staff should aim at the patient's own situation,take the patient's needs as the guidance,strengthen the health knowledge imparting and self-management education related to the patient's disease,and popularize the self-management skills of young stroke patients more comprehensively.To enable patients to learn how to correctly manage the disease,improve patients'confidence in self-management on their own initiative.