A Study On The Variation Curve Of Self-management Level In Patients With First-ever Stroke

Objective By analyzing the influencing factors of stroke patients’ self-management level and drawing the variation curve,we explored the relationship between self-management level and the onset time of patients with first-ever stroke to provide a theoretical basis for clinical intervention in stroke self-management methods.It can promote the progress of nursing scientific research and academic development,save medical resources,and reduce medical expenses.Methods1.Select 88 patients with first-ever stroke who were enrolled in Department of Neurology at two of the top three hospitals in Hangzhou,Zhejiang Province from December 2016 to April 2017,the scores of stroke patients’ self-management level,and measured them for the first time within 3 days after admission.After that,every 2 weeks,it was measured continuously until the 24 th week,By using self-designed general information questionnaire and brief mental status scale(MMSE)and chronic disease self-management research scale(CDSMSA).2.SPSS19.0 was used to deal with the data,the mean and standard deviation were used to describe the statistics,and the influencing factors of self-management were analyzed by univariate analysis and multivariate regression analysis.3.The curve fitting was carried out by MATLAB,and the variation curve of self-management level was obtained by Polynomial model.Results1.The age of the surveyed subjects was 23 to 80(55.16±11.73)years old,and the trend of younger onset was obvious;67% of patients with chronic illness with one or more previous medical history were included;the main caregivers included immediate family members,babysitters and others,among which immediate family members Accounting for57.9%,nanny accounted for 33%;the BMI index was 53.5% abnormal;25% of patient stated that they had never gotten health knowledge through any means.2.Horizontal observations showed that the average score of the self-management behavior scale was 32.88±9.56 points,and the average score of the self-efficacy scale was24.70±4.48;and the longitudinal observation showed that,during the 24-week observation period,the average score of self-management behavior scale was 32.88 ±9.56,and that of self-efficacy scale was 24.70±4.48.The mean score of self-management was 66.30±10.98,the peak was 70.35 ± 10.65 at the 10th week,and the lowest was 57.60 ± 14.29 at admission.3.The results of single factor analysis showed that the total self-management scores of stroke patients were statistically significant at different ages,education levels,medical payment methods,main caregivers,and gender(P<0.05);multiple regression analysis showed that the main factors affecting the self-management level are education,age,and main caregivers.4.The curve of self-management level variation was fitted by Polynomial model.The curve equation was Y=0.002592 X^3-0.1654X^2+ 2.607X+ 58.39.The curve is in a parabolic form and the level of self-management changes with time.Conclusion1.The self-management level of stroke patients under investigation needs to be improved.The average score is lower than the norm,especially in the management of cognitive symptoms.2.The main influencing factors of self-management in the first-ever stroke patients were age,education level and main caregivers3.The self-management level of stroke patients surveyed shows a parabola-like dynamic change with time,which may be related to the time of onset of stroke patients and the timeliness of interventions.During the decline of self-management level,timely re-nursing interventions will help maintain a higher level of self-management and promote patients rehabilitation.