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Received:May 12, 2023 Published Online:February 20, 2024
Received:May 12, 2023 Published Online:February 20, 2024
中文摘要: 目的 探索高血压脑出血患者急性期症状群组成，并分析其与预后生活质量的相关性。方法 选取2021年7月至2022年6月唐山市两所三级甲等医院神经外科住院的396例高血压脑出血患者，采用一般资料调查表、记忆症状评估量表、脑卒中专用生活质量量表进行调查，采用探索性因子法提取症状群并运用偏相关性分析法分析症状群与生活质量间的相关性。结果 高血压脑出血患者急性期发生率较高的症状包括食欲不振（77.3%）、精力不足/乏力（74.0%）、疼痛（72.9%）、体重下降（71.5%）、感到紧张（70.7%）等；症状严重程度得分较高的症状包括食欲不振（2.01±1.22）、精力不足/乏力（2.00±1.32）、疼痛（1.97±1.30）、作呕/恶心（1.83±1.21）、难以集中精神（1.81±1.30）；困扰程度得分较高的症状包括疼痛（2.27±1.53）、作呕/恶心（2.20±1.48）、呕吐（1.98±1.59）、精力不足/乏力（1.96±1.30）、眩晕（1.81±1.40）。探索性因子法共提取6个症状群，即消化系统症状群、心理症状群、疼痛—疲乏相关症状群、肢体—认知障碍症状群、言语—吞咽障碍症状群和肺炎相关症状群，均与预后生活质量呈负相关性，相关系数分别为-0.261、-0.388、-0.335、-0.513、-0.304、-0.273。结论 高血压脑出血患者急性期存在6个症状群且均与预后生活质量呈负相关，提示医务人员应及时、准确识别或预测症状群，优化症状管理策略，从而提高患者预后生活质量。
Abstract:Objective To explore the composition of symptom clusters in the acute phase of patients with hypertensive cerebral haemorrhage and to analyse their correlation with prognostic quality of life. Methods From July 2021 to June 2022, 396 patients with hypertensive cerebral haemorrhage hospitalised in neurosurgery departments of two tertiary care hospitals in Tangshan City were selected and surveyed using the General Information Questionnaire, the Memory Symptom Assessment Scale and the Stroke-Specific Quality of Life Scale. An exploratory factor method was used to extract symptom clusters and Biased correlation analysis was applied to analyse the correlation between symptom clusters and quality of life. Results Symptoms with a higher incidence in the acute phase in patients with hypertensive cerebral hemorrhage included loss of appetite (77.3%), low energy/weakness (74.0%), pain (72.9%), weight loss (71.5%), and feeling nervous (70.7%); symptoms with a higher degree of severity included loss of appetite (2.01±1.22), low energy/weakness (2.00±1.32), pain (1.97±1.30), vomiting/nausea (1.83±1.21), difficulty concentrating (1.81±1.30); symptoms with higher levels of distress included pain (2.27±1.53), vomiting/nausea (2.20±1.48), vomiting (1.98±1.59), low energy/weakness (1.96±1.30), dizziness (1.81±1.40). A total of six symptom clusters were extracted by the exploratory factor method, namely digestive symptom cluster, psychological symptom cluster, pain-fatigue related symptom cluster, physical-cognitive impairment symptom cluster, speech-swallowing disorder symptom cluster and pneumonia related symptom cluster, all of which were negatively correlated with prognostic quality of life with correlation coefficients of-0.261,-0.388,-0.335,-0.513,-0.304,-0.273. Conclusion The presence of six symptom clusters in the acute phase of hypertensive cerebral haemorrhage patients, all of which were negatively associated with prognosis of quality of life, suggests that medical staff should identify or predict symptom clusters in a timely and accurate manner and optimise symptom management strategies to improve patients ‘ prognosis of quality of life.
keywords: Cerebral haemorrhage Stroke Symptoms cluster Symptom management Quality of life Exploratory factor analysis
文章编号： 中图分类号：R743.34 R544.1 文献标志码：A
基金项目:河北省医学科学研究课题计划（20221544）
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