Current Situation Analysis And Intervention Study Of Dyadic Coping Between Post-stroke Depression Patients And Their Spouses

BackgroundStroke is the first cause of death and disability in adults in China.It has the characteristics of high incidence rate,high disability rate,high mortality rate and high recurrence rate.The incidence rate,incidence rate and mortality rate of stroke in China are basically the trend of "high in the north and low in the south,and prominent in the middle part",while the incidence and mortality of stroke in Northeast China are the highest.Post stroke depression is one of the most common complications of stroke,which has an important negative impact on the functional rehabilitation of stroke patients and their return to society.Spouses are the primary care resources of stroke patients,and bear greater physiological,psychological,economic and social pressure.Dyadic stress refers to the pressure and challenge that both partners face together.Dyadic coping refers to the common reaction and strategy of both partners when they face dyadic stress events.Therefore,to explore the dyadic coping status of couples with post-stroke depression,to determine its influencing factors,and to develop dyadic coping interventions suitable for Chinese patients with post-stroke depression and their spouses,focusing on the communication,support and common coping between partners.It is of practical significance and practical value to enhance the positive response of partners to the pressure of life caused by the spouse suffering from stroke,especially depression,and to improve the depression symptoms of patients.Objectives1.To investigate and analyze the dyadic coping status and influencing factors between stroke patients and their spouses and between post-stroke depression patients and their spouses in Qiqihar city.2.Formulate and implement dyadic coping intervention suitable for patients with post-stroke depression and their spouses,and verify its intervention effect on patients with post-stroke depression and their spouses.Methods1.1016 stroke patients admitted to the Department of Neurology and Neurosurgery of three comprehensive Grade-A hospitals in Qiqihar and their spouses who met the inclusion criteria were investigated with self-designed general information questionnaire,9 Item patient health questionnaire Depression Scale(PHQ-9)and dyadic coping inventory(DCI).2.Formulate dyadic coping intervention program,The patients and their spouses who met the inclusion criteria of the intervention study were randomly divided into intervention group and control group.The intervention group was given dyadic coping intervention,and the control group was given placebo intervention.3.Use SPSS 25.0 to analyze the data,The counting data is described by the number of cases and the constituent ratio;The measurement data accorded with the normal distribution and were statistically described by((?)±s).Single sample t-test,independent sample t-test,variance analysis,nonparametric test and multiple linear regression were used to analyze the status and influencing factors of dyadic coping;Independent sample t-test,paired t-test and continuous measurement ANOVA were used to evaluate the intervention effect.Results1.The total score of dyadic coping scale was(123.91 ± 22.69),and that of their spouses was(123.90 ± 22.44),higher than the average value of dyadic coping(P<0.001).Income,limb dysfunction and depression were the main influencing factors of dyadic coping of stroke patients.The main influencing factors of dyadic coping of stroke patients’ spouses were spouse depression,limb dysfunction,marriage history and marriage age(P<0.05).The total score of dyadic coping was(105.62±16.71)),spouse(106.46±16.24),which was lower than the average of dyadic coping(P<0.001).The common influencing factors of dyadic coping were the number of complications and marriage history.In addition,the influencing factors of dyadic coping of post-stroke depression patients also included physical dysfunction,and the influencing factors of dyadic coping of spouses also included education level,number of chronic diseases and marriage age(P<0.05).2.The total score of dyadic coping between PSD patients and their spouses in the intervention group was significantly higher than that in the control group(P<0.001),and the PHQ-9 score in the intervention group was significantly lower than that in the control group(P<0.001);The total score of dyadic coping after intervention was higher than that before intervention and at follow-up(P<0.001).There was no significant difference in the total score of dyadic coping between the control group and the spouse group(P>0.05).PHQ-9 in the intervention group and the control group was significantly lower than that after and before the intervention(P<0.001).Conclusions1.The dyadic coping of stroke patients and their spouses was normal,and the score of dyadic coping scale of post-stroke depression patients and their spouses was lower than the average,which was affected by marital status and physical status.2.The psychological intervention form of dyadic coping can improve the level of dyadic coping of post-stroke depression patients and their spouses,and reduce the degree of depression of patients.