Demand And Influencing Factors Of Stroke Survivors And Caregivers

Objective Stroke,referred to as "cerebrovascular disease",is recognized as a common health problem worldwide,and is the main cause of death and acquired disability worldwide.However,the long-term needs and rights awareness of stroke survivors and caregivers are rarely reported in China.The purpose of this study was to explore the actual needs of stroke survivors and caregivers in Ninghe district of Tianjin,and to compare the needs of survivors and caregivers in rural areas and towns.In order to improve the needs of stroke survivors and caregivers in this region,we put forward useful suggestions,improve the quality of life of survivors after stroke,and contribute to secondary prevention of stroke.Methods In this study,the needs of stroke survivors and their caregivers were assessed by questionnaires.The questionnaire was designed by the World Stroke Organization.On the basis of the questionnaire,it was improved and supplemented according to the specific situation of our country.A questionnaire survey was conducted among 995 stroke survivors and 993 caregivers in Ninghe District Hospital of Tianjin from August 2015 to December 2017 to understand their general situation,psychological needs,stroke knowledge,diagnosis,treatment,nursing,rehabilitation and social support needs.According to the residence of survivors,stroke survivors and caregivers were divided into rural and township groups.Through multiple linear regression analysis,the possible influencing factors of the needs of stroke survivors and caregivers were explored;and compares the needs of rural and township survivors,and the needs of rural caregivers and township caregivers.Results(1)This study included 995 stroke survivors,including 570 rural survivors and 425 township survivors.94.1% of the survivors needed psychological support,followed by clinical diagnosis,treatment and nursing(78.0%),stroke knowledge(72.4%),rehabilitation and social support(53.7%).The demands of township survivors in psychological,stroke knowledge,clinical diagnosis and treatment,nursing,rehabilitation and social support were higher than those of rural survivors(P<0.05).(2)The higher the educational level of survivors,the older the age at onset,the greater the total demand(P=0.000,0.006).The younger the survivors,the lower the NIHSS score,the shorter the time from the first onset to the investigation,and the higher the total demand(P=0.001,0.000,0.048).Male survivors had higher demands than female survivors(P=0.014).The higher the educational level of the survivors,the greater the need for stroke knowledge,psychological,diagnostic and therapeutic care,rehabilitation and social support(P <0.05).The younger the survivor's age,the greater the need for psychological,diagnostic and therapeutic care,rehabilitation and social support(P <0.05).The older the age of onset,the greater the need for psychological,diagnostic and therapeutic care,rehabilitation and social support(P <0.05).The lower the NIHSS score,the higher the need for diagnostic and therapeutic care,stroke knowledge,rehabilitation and social support(P<0.05).Male survivors need more psychological needs and stroke knowledge(P <0.05).(3)The average age of onset of stroke in rural areas is larger than that in township survivors(P<0.05),The educational level of township survivors with stroke is higher than that of rural areas(P<0.05).(4)In this study,993 stroke caregivers were included,including 541 rural caregivers and 452 Township caregivers.From the perspective of stroke caregivers,the highest demand for psychological support was 96.3%,followed by stroke knowledge(88.8%),clinical diagnosis and nursing(84.4%),rehabilitation and social support(69.2%).The needs of township caregivers in psychological needs,clinical diagnosis and treatment,nursing,stroke knowledge,rehabilitation and social support were higher than those of rural caregivers(P<0.001).(5)The higher the educational level of caregivers,the longer the time from the first onset to the investigation,the greater the total demand(P =0.000).The higher the educational level of caregivers,the greater the need for psychological needs,diagnostic and therapeutic care,rehabilitation and social support,and stroke knowledge(P <0.05).The older the caregivers are,the greater the need for diagnostic and therapeutic care(P =0.023).The longer the time from the first onset to the investigation,the greater the need for psychological needs,rehabilitation and social support,and stroke knowledge(P <0.05).The shorter the time from the first onset to the investigation,the greater the need for diagnostic and therapeutic care(P =0.000).The need for rehabilitation and social support was greater in the survivors with ischemic stroke cared for(P <0.05).The lower the NIHSS score of the survivors cared for,the more they wanted to acquire knowledge about stroke(P <0.05).Conclusions(1)Stroke survivors and caregivers have high demands on psychology,diagnostic and therapeutic care,stroke knowledge,rehabilitation and social support.Among the four dimensions of needs,survivors have the highest degree of psychological needs,the order of needs is psychological needs,diagnostic and therapeutic care,stroke knowledge,rehabilitation and social support needs;caregivers also have the highest level of psychological needs,the order of needs is psychological needs,stroke knowledge,diagnostic and therapeutic care,rehabilitation and social support.(2)The needs of stroke survivors and caregivers in towns are higher than those in rural areas in terms of psychology,stroke knowledge,diagnostic and therapeutic care,rehabilitation and social support.(3)The results suggest that attention should be paid to the needs of stroke survivors and caregivers,especially psychological needs.Improve the rehabilitation nursing system in rural areas,strengthen community health education,improve public awareness of stroke prevention,optimize the process of stroke diagnosis and treatment,and improve the prognosis of stroke survivors.