摘要
目的探讨生命关怀视角下空巢老年急性期缺血性脑卒中患者自杀意念及自杀行为的影响因素,为降低脑卒中患者自杀风险提供参考。方法对2017年6月~2018年6月期间在哈尔滨医科大学附属第一医院住院治疗的248例急性期缺血性脑卒中患者进行问卷调查,收集患者的性别、年龄、文化程度、居住地、脑血管病并发症、神经功能缺损程度、抑郁程度、自杀意念水平、社会支持以及家庭关怀状况等资料。按照是否具有自杀意念分为有自杀意念组和无自杀意念组。6个月后对患者进行电话随访,主要随访患者病情康复情况以及是否有自杀行为。结果 248例急性期缺血性脑卒中患者全部完成问卷调查,有23例患者有自杀意念,发生率为9.27%。多因素logistic回归分析显示,居住在农村、美国国立卫生研究院卒中量表(NIHSS)评分高、抑郁自评量表(SDS)评分高以及家庭关怀指数(APGAR)评分低为急性期缺血性脑卒中患者自杀意念的独立危险因素(P <0.05)。6个月后随访,有自杀意念组和无自杀意念组的自杀行为发生率差异有统计学意义(P <0.05)。结论居住在农村、神经缺损程度严重、合并抑郁及家庭功能障碍的空巢老年患者更容易出现自杀意念,治疗过程应该予以足够重视,降低自杀风险。
Objective To explore the influential factors of suicidal ideation and suicidal behavior in empty nesters with acute ischemic stroke from the perspective of life care.Methods A total of 248 empty nesters with acute ischemic stroke were investigated by questionnaire in the First Affiliated Hospital of Harbin Medical University from June 2017 to June 2018.The information of sex,age,educational level,residence place,complications of cerebrovascular disease,neurological deficits,depression,suicidal ideation,social support and family care were documented.The patients were divided into the group with suicidal ideation and the group without suicidal ideation.After 6 months,a servey for the rehabilitation status and suicidal behavior of the patients was conducted by telephone follow-up.Results All 248 patients with acute ischemic stroke completed the questionnaire survey.There were 23 patients with suicidal ideation,the incidence was 9.27%.Multivariate logistic regression analysis showed that living in rural areas,high national institutes of health stroke scale(NIHSS)score,high self-rating depression scale(SDS)score,and low family APGAR index score were the independent risk factors of suicidal ideation in patients with acute ischemic stroke(P<0.05).Follow-up after 6 months showed that there was significant difference in the incidence of suicidal behavior between the group with suicidal ideation and group without suicidal ideation(P<0.05).Conclusion The older empty nesters with acute ischemic stroke who live in rural areas,have serious neurological deficit,depression,and family dysfunction are more likely to develop suicidal ideation.We should pay enough attention to the treatment process to reduce the risk of suicide.
作者
关震
关冰
何宝婷
张伟
Guan Zhen;Guan Bing;He Baoting;Zhang Wei(Department of Neurology,the First Affiliated Hospital,Harbin Medical University,Harbin 150000,China)
出处
《国际老年医学杂志》
2020年第6期354-356,377,共4页
International Journal of Geriatrics
基金
国家临床重点专科建设项目经费资助(2012--649)。
