The Relationship Among Sense Of Coherence And Coping Style And Emotional And Social Dysfunction In Elderly Stroke Patients

Objectives To understand the existing circumstances and influencing factors of sense of coherence and coping style and emotional and social dysfunction in elderly stroke patients;To discuss the relationship among sense of coherence and coping style and emotional and social dysfunction,to provide reference basis for promoting the physical and emotional health quality of elderly stroke patients.Methods From October 2019 to September 2020,403 elderly stroke patients admitted to the Department of Psychiatry of Hebei Province People’s Hospital in this study.They were assessed with a questionnaire after informed consent and stable condition.The Emotional and Social Dysfunction Scale was used to estimate the extent of emotional and social dysfunction,Sense of Coherence Scale was used to test the degree of sense of coherence,and Medical Coping Style Questionnaire was used to determine different coping styles.General Condition Questionnaire,Social Support Scale,Family Care Index Questionnaire and Barthel Index Scale were used to collect demographic,disease-related,health-related and family-social data of elderly stroke patients.Excel and SPSS22.0 software were used for data processing and analysis,general data features and scores of each scale were described and analyzed.T-test,ANOVA and multiple linear regression analysis were used for influencing factors analysis,and Pearson correlation analysis and Wen Zhonglin’s mediating effect test were used for the relationship among the three variables.Results 1 The score of sense of coherence in elderly stroke patients was(63.01±14.69).Multifactorial results showed that literacy,duration of illness,knowledge of the disease,family care and social support were included in multiple linear regression equation(P<0.05).2 Confrontation score of elderly stroke patients was(15.53±4.19),which was lower than the norm;avoidance score was(15.04±2.44)and submission score was(11.43±3.43),which were higher than the norm.Regression analysis indicated literacy,marital status,previous employment,personality,stroke type,frontal lobe stroke or not,sleep quality,disease knowledge,family care,and social support had influence on different coping styles(P<0.05).3 The total score of emotional and social dysfunction in elderly stroke patients was(76.07±17.16),with a score of 56.3%,which was at a moderate level.Multiple linear regression results indicated that age,literacy,incidence,stroke in frontal lobe or not,duration of illness,disability,family care,social support,sense of coherence and coping style were factors of emotional and social dysfunction in elderly stroke patients(P<0.05).After controlling for other factors,sense of coherence had an independent negative effect on emotional and social dysfunction(β=-0.103,P<0.05),while coping style had an independent positive effect on emotional and social dysfunction(β=0.195,P<0.05).4 Correlation analysis showed that sense of coherence and confrontation were negatively associated with emotional and social dysfunction(r=-0.730,-0.669,P<0.05),avoidance and submission were positively correlated with emotional and social dysfunction(r=0.479,0.679,P<0.05).The results of the mediation effect test showed that sense of coherence had direct negative effect on emotional and social dysfunction with a total effect size of-0.730,and that the three coping styles of confrontation,avoidance,and submission played a partial mediating effect between sense of coherence and emotional and social dysfunction in elderly stroke patients.The mediating effect sizes of the three coping styles were-0.218,-0.073 and-0.229,accounting for 29.9%,10.0% and 31.4% of the total effect sizes,respectively(P<0.05).Conclusions 1 Elderly stroke patients have a moderately low level of sense of coherence.With high literacy,short duration of illness,knowledge of the disease,good family care,and high social support as positive factors to increase level of sense of coherence.2 Elderly stroke patients are more likely to choose both avoidance and submission to cope with the disease.The patient’s literacy,marital status,previous employment,personality,stroke type,frontal lobe stroke or not,sleep quality,disease knowledge,family care,and social support influence the choice of coping style.3 The emotional and social dysfunction of elderly stroke patients is not optimistic and needs to be enhanced.The elderly stroke patients with advanced age,low literacy,frequent incidence,stroke in frontal lobe,long duration of illness,serious disability,poor family care,low social support,low sense of coherence and negative coping style have more serious degree of emotional and social dysfunction.4 Sense of coherence and confrontation are moderate negatively associated with emotional and social dysfunction,avoidance and submission are positively correlated with emotional and social dysfunction;sense of coherence and coping style can not only have direct influence on emotional and social dysfunction in elderly stroke patients independently,but also sense of coherence has indirect effects on emotional and social dysfunction with confrontation,avoidance and submission as the mediating variable.Figure 3;Table 30;Reference 135...