To explore the potential classification of anxiety symptoms in stroke patients' spouses and analyze the characteristics of each category. From November 2019 to August 2020, a total of 224 stroke patients in the department of neurology of a tertiary hospital in Henan Province, and 224 spouse caregivers were conveniently selected. The general information questionnaire, Generalized Anxiety Disorder 7-item, the Patient Health Questionnaire 9-item scale, and modified Rankin Scale was used to assess patient and caregiver general information, anxiety, depression and patient prognosis, respectively. Latent profile analysis was used to analyze stroke patients' spouse anxiety symptoms, and polynomial logistic regression analysis was performed to assess factors associated with each category. The mean age of the patients were 62.54 years and the patients' spouses were 62.23 years. The patients' spouse anxiety symptoms were categorized into four groups: high anxiety-worry (13.4%); high anxiety-adaptive (58.9%); medium anxiety-high toughness (7.6%); anxiety-low risk (20.1%). There is heterogeneity in the anxiety symptoms of spouse caregivers of stroke patients, and nurses should develop targeted interventions based on the anxiety characteristics of different potential categories of spouse caregivers and their influencing factors in order to improve their anxiety symptoms.

BackgroundThere is heterogeneity in depressive symptoms. However, latent classes of depressive symptoms and the transition and influences of these in young and middle-aged stroke patients are unclear.ObjectivesThe aim of this study was to identify the latent classes of depressive symptoms and their transition patterns over time and the influencing factors in young and middle-aged stroke patients from stabilization to 6 months after discharge.MethodsThis is a longitudinal study following the Strengthening the Reporting of Observational Studies in Epidemiology checklist. A total of 272 young and middle-aged stroke participants were recruited from a hospital neurology ward in Henan Province, China. Participants completed a questionnaire on sociodemographic and health information. Latent transition analysis was used to evaluate the transition pattern of latent classes from stabilization to 6 months after discharge and its influencing factors.ResultsOne hundred seventy-nine participants were included in the analysis. Three latent classes of depressive symptoms were identified as "mild symptoms," "grief-sleep-fatigue symptoms," and "severe symptoms." Most participants remained in the original latent class from stabilization to 6 months after discharge (probability of 83.8%, 83.8%, and 88.8%). From 3 to 6 months after discharge, the participants with fewer complications were more likely to transition into the mild symptom class.DiscussionThe findings indicate that from stabilization to 6 months after discharge, depressive symptoms in young and middle-aged stroke patients in China transitioned gradually from the severe symptom class to the mild symptom. Patients with fewer numbers of poststroke complications were more likely to transition to the mild symptoms class. Future research should focus on depressive symptoms in early-stage stroke patients and provide sufficient psychological support to patients with a high number of complications.

Objective: Risk perception is critical to the formation of individual health prevention behaviors. A long-term accurate perception of stroke recurrent risks is imperative for stroke secondary prevention. This study aims to explore the level of recurrence risk perceptions and the influential factors of inaccuracy between perceived and objective risk in first-ever ischemic stroke patients from a rural area. Methods: From May to November 2020, 284 first-ever ischemic stroke patients were conveniently recruited in a rural area of Henan Province, China. Perceived risk was measured based on self-reported using a numerical rating scale, whereas the objective risk was measured by the Essen Stroke Risk Score. Patients' perceived risk was compared with their objective risk and categorized as "Accurate," "Underestimated," and "Overestimated." The influencing factors of inaccuracy were further evaluated using multivariate regression analyses.Results: 46% of the participants underestimated their stroke risk, while 15.9% overestimated their risks. Patients who were younger (& LE;65 years), didn't worry about recurrent stroke, and had a low actual recurrent risk were more likely to underestimate their recurrent risk. Patients who were employed, had lower independence, and had greater anxiety were more likely to overestimate their recurrent risk.Conclusions: The majority of participants were unable to accurately perceive their own risk of stroke recurrence. Patients' age, working status, worry about recurrent stroke, actual recurrent risk, level of dependence, and anxiety played a role in perception inaccuracy. Practice implications: The findings could help healthcare providers gain a better understanding of the level and accuracy of recurrence risk perceptions among first-ever stroke patients in the rural area. Future counseling on the perceived risk of stroke recurrence and individual objective risk assessment could be conducted to help patients better understand their risk of recurrence. Individualized risk communication and multidisciplinary teamwork can be developed to improve the accuracy of recurrence risk perceptions and health behaviors.

Objective Latent class analysis（LCA） was used to explore the latent classes of depressive symptoms in spouse caregivers of stroke patients and analyze the influencing factors.Methods The convenience sampling method was used to select 390 couple of stroke patients in the Neurology Department of a tertiary A hospital in Henan province.General information questionnaire, modified rankin scale, perceived stress scale, stroke caregiver perception of benefit questionnaire, and patient health questionnaire-9 were used for a survey.Depressive symptoms of spouse caregivers were classified using LCA and the effect of each factor on the different latent classes was analyzed using multinomial Logistic regression.Results Depressive symptoms of spouse caregivers were divided into sleep disorder（31.0%）,emotional-physiological depression（12.8%）,and low risk of depression（56.2%）.The disordered multiple Logistic regression results showed that spouse caregiver’s education level, perceived stress, and benefit findings were predictors of latent classes of depressive symptoms（all P＜0.05）. Conclusions There are three latent classes of depressive symptoms in spouse caregivers of stroke patients.Doctors and nurses should develop targeted interventions to alleviate spouse caregivers’ depressive symptoms based on different classes and their influencing factors.

Objective To explore the categories of dyadic depression and related factors among stroke patients and their spouses.Methods A total of 224 dyads of stroke patients and their spouses were recruited in the Neurology Department of a tertiary general hospital from November, 2019 to August, 2020.The general information questionnaire, PHQ-9,PSS,Modified Rankin Scale, C-PTGI and Caregiver Benefit Finding Scale were used for investigation.Latent profile analysis was adopted to explore the categories of dyadic depression, and multiple logistic regression was used to analyze the predictors of each category.Results Categories of dyadic depression among stroke patients and their spouses included patient and spouse with no depression, patient with severe depression-spouse with mild depression, patient with moderate depression-spouse with no depression, patient with mild depression-spouse with moderate depression.Taking the category of patient and spouse with no depression as the reference, the C-PTGI score, poor prognosis, disease duration（≥1 year）,monthly household income（＜ 2,000 yuan）,patients’ PSS score, stroke occurrence（≥3）,caregiver benefits were predictors（all P＜0.05）.Conclusions Dyadic depression exists in the populations of stroke patients and their spouses, which demonstrates different categories.Nurses should carry out comprehensive psychological interventions for stroke patients and their spouses with different depressive characteristics, so as to alleviate their depression.

The associations of physical activity (PA) intensity and types with CVD (cardiovascular diseases) in different population are inconsistent and remains not very clear. A total of 7854 males and 10,876 females over 15 years were selected by multistage random sampling methods. In males, moderate-intensity physical activity (MPA) had no effect, while vigorous-intensity physical activity (VPA) played a significant protective role (OR = 1.319 and 0.615). However, in females, both MPA and VPA had significant protective effects (OR = 0.593 and 0.537). VPA presented as a significant protective factor in stroke patients and combined CVDs for males in all age groups; however, in females, the results suggested that, for those aged over 60–74 years, MPA was a protective factor. Furthermore, for the middle-aged or younger participants, the area under the curves (AUCs) of work, housework, and leisure activity were generally higher than that of other types, while for patients aged over 60 years, the AUCs of sedentary time and sleep activity seemed much higher. VPA had a better protective effect for preventing cardiovascular events, while the young and female population could benefit from MPA as well. Regardless of the types of PA, leisure activities were strongly recommended, and young people were much more likely to benefit from exercise than older people.

Objective: To describe the Physical Activity and Exercise (PAE) adherence of stroke survivors in rural regions, additionally, to analyze the influential factors through age stratification. Methods: This is a cross-sectional study. Totally, 596 stroke patients (65.70 +/- 10.76 years) from three rural regions were selected, PAE scale was used for measuring compliance. The influential factors among different age groups were explored separately. This study adheres to the EQUATOR checklist, SROBE. Results: Only 17.8% (106) of participants regularly participated in PAE. Altogether, 42.45% were classified as a young-middle age group, and the rest 57.55% were in the old age group. Positive attitudes and better PAE-relevant knowledge were protective factors for adherence in the young and middle-aged group (OR=0.683; 95% CI 0.173 similar to 0.588 and OR=0.939; 95% CI 0.013 similar to 0.114), as well as in the old group (OR=0.704; 95% CI 0.193 similar to 0.534 and OR=0.929; 95% CI 0.035 similar to 0.118); having no home rehabilitation equipment was a strong risk factor for younger patients (OR=16.078; 95% CI 1.235 similar to 4.320); however, without hemiplegia can positively affect their adherence (OR=0.891; 95% CI 0.045 similar to 0.229). In addition, the presence of a spouse can lead to a better compliance among old patients (OR=0.436; 95% CI -0.496 similar to-0.165). Conclusion: It is necessary to improve the knowledge of physical activity in rural stroke patients of all ages. It is of great significance to install home rehabilitation equipment to promote exercise for young and middle-aged stroke patients. While for the old stroke patients, we strongly suggest focusing on the role of spouses, which would be more useful in low-income regions.

目的:调查郑州市城乡地区脑卒中患者出院3个月后的疾病复发风险意识,分析其影响因素,为制定脑卒中复发风险管理方案提供依据.方法:选取郑州市3家三级及以上医院内出院3个月后的脑卒中患者进行电话随访调查.结果:3586出院脑卒中患者中接受调查者995例,平均年龄(63.45±13.46)岁.城市脑卒中患者复发风险意识略高于农村患者(P<0.05).Logistic回归分析显示,文化程度高、无业或退休、老年人、接受过医院随访的城乡脑卒中患者更能主观意识到卒中具有复发风险,但复发次数却与个体复发风险意识无显著关联.结论:城乡脑卒中患者普遍缺乏复发风险意识,城市患者复发风险意识略强于农村患者;未来可探索基于地区特征的院内复发风险沟通教育模式,构建适宜的城乡脑卒中患者复发风险管理方案.

背景 疾病复发风险自我感知已得到国外众多学者关注,但国内尚缺乏脑卒中复发风险自我感知相关研究.目的 分析农村缺血性脑卒中患者脑卒中复发风险自我感知与客观复发风险的一致性及对策.方法 采用方便抽样法选择2020年5—8月在安阳市滑县人民医院神经内科住院的农村缺血性脑卒中患者295例作为调查对象,采用自设问卷收集相关信息,主要包括人口学特征、复发担忧程度、残障程度、脑卒中客观复发风险、脑卒中复发风险自我感知等.结果 295例患者中Essen卒中风险评估量表评估结果为低风险者144例(48.8％),中等风险者151例(51.2％),高等风险者0例;脑卒中复发风险自我感知为低危者152例(51.5％),中危者47例(15.9％),高危者45例(15.3％),不清楚者51例(17.3％);一致性分析结果为低估者69例(23.4％),准确者115例(39.0％),高估者60例(20.3％),无法判断者51例(17.3％).不同Essen卒中风险评估量表评估结果患者脑卒中复发风险自我感知、一致性分析结果比较,差异有统计学意义(P<0.05).Spearman秩相关分析结果显示,农村缺血性脑卒中患者Essen卒中风险评估量表评估结果与一致性分析结果呈负相关(rs=-0.498,P<0.001).多因素Logistic回归分析结果显示:性别、体质指数(BMI)、职业、合并症数量、复发担忧程度是农村缺血性脑卒中患者一致性分析结果为低估的影响因素,而BMI、职业、主要照顾者、复发担忧程度是农村缺血性脑卒中患者一致性分析结果为准确的影响因素(P<0.05).结论 农村缺血性脑卒中患者脑卒中复发风险自我感知与客观复发风险的一致性分析结果准确率较低,且不同脑卒中客观复发风险患者脑卒中复发风险自我感知、一致性分析结果存在差异;性别、BMI、职业、合并症数量、家庭人均月收入、复发担忧程度是农村缺血性脑卒中患者一致性分析结果为低估的影响因素,而BMI、职业、主要照顾者、家庭人均月收入、复发担心程度是农村缺血性脑卒中患者一致性分析结果为准确的影响因素.

目的 了解首发与复发脑卒中患者的疾病体验,探讨脑卒中患者复发风险感知的特征及变化.方法 采用现象学研究方法,对19例脑卒中患者进行半结构式深入访谈,运用Colaizzi 7步分析法对访谈资料进行分析.结果 首发、首次复发和多次复发脑卒中患者的疾病体验和复发风险感知各有特征.首发脑卒中患者:可识别异常但缺乏专业信息渠道,主动就诊意识强并感知及时就诊益处大,预后态度过于乐观易忽略复发风险;首次复发脑卒中患者:复发警示症状感知水平有待提高,感知复发严重且能自觉反思,复发担忧、疾病控制无力感与无用感交织;多次复发脑卒中患者:社会参与能力明显下降,质疑行为改变益处,积极或消极接受复发且生死观话题突出.结论 首发与复发脑卒中患者的疾病体验和复发风险感知水平不同,普遍存在复发风险意识不足的现象,建议根据发作次数设计分类健康指导方案,关注复发风险并实施风险沟通教育,提高脑卒中患者疾病认识和复发风险感知水平.

目的 了解患者创伤后成长发生发展的具体过程,为创伤后不同阶段心理干预提供实证支持.方法 以目的 抽样法选择12例中青年脑卒中患者,分别在出院前1d、出院后3个月、6个月3个时间点进行深度面对面半结构化访谈,运用扎根理论法对访谈资料进行整理分析.结果 中青年脑卒中患者创伤后成长轨迹可归纳为破坏与应激、重建与困苦、成长的融合3个阶段;3个阶段并非线性递进关系,而是处于动态演变的情景之中.创伤后成长轨迹有3种类型,分别为持续应激、逐渐成长、成长回落.结论 中青年脑卒中患者创伤后成长呈现为非线性递进的3个阶段和3种成长轨迹,医护人员可参照实施针对性干预.

AIMS To understand how survivors of stroke perceive secondary prevention and explore their perceived barriers and facilitators using the Theoretical Domains Framework. DESIGN A qualitative descriptive study. METHODS Nineteen survivors of stroke from three hospitals were recruited and interviewed from April 2019 to April 2020. The data were analysed deductively and inductively by content analysis strategies. RESULTS Three main themes of perception of secondary prevention were identified, these being active treatment-seeking, attention to taking medications and negative attitude towards lifestyle changes. Using deductive analysis, eight domains of the Theoretical Domains Framework were reported to be relevant in the secondary prevention behaviour of survivors of stroke that mapped to five 'barrier' domains (i.e. knowledge, physical skills, beliefs about capability, beliefs about consequences and optimism) as well as six 'facilitator' domains (i.e. knowledge, interpersonal skills, beliefs about capability, intention, emotion and social influences). Using inductive analysis we identified two additional important factors not falling in the domains of the Theoretical Domains Framework. These comprised female spouses' support and patients' economic autonomy, both of which could be classified as a facilitator or barrier. CONCLUSION Survivors of stroke perceive seeking treatment and using preventive medication as more important than modifying lifestyle behaviours. Knowledge and insight into the barriers and facilitators of secondary prevention in this specific context provides a theoretical and practical basis for the design of future secondary prevention interventions. IMPACT Stroke survivors' perceptions of secondary prevention, barriers and facilitators were explored in the context of a developing country. These findings highlight the need to better communicate the importance of improving lifestyle modification and medication adherence, and provide evidence for designing relevant interventions for stroke management in the community.

为深入了解中青年脑卒中患者创伤后成长的真实体验,运用现象学研究方法,选取10例受访者进行深度面对面半结构化访谈,访谈资料采用Colaizzi现象学分析法进行整理分析.提炼主题可归纳为中青年经历脑卒中后的心理痛苦、中青年患者创伤后成长促进因素及中青年患者创伤后成长体验三个部分.中青年脑卒中患者存在创伤后成长这一积极心理体验,为临床心理护理干预提供新的切入点.临床医护人员应关注患者早期创伤反应及压力源,从促进因素入手,激发中青年患者的潜能和力量,充分利用其心理资源以达到身心适宜的状态.