Ni Chunping, Peng Jing, Wei Yuanyuan, Hua Yan, Ren Xiaoran, Su Xiangni, Shi Ruijie
Questions or comments about this article may be directed to Chunping Ni, PhD, at
J Neurosci Nurs. 2018 Aug;50(4):238-243. doi: 10.1097/JNN.0000000000000373.
Uncertainty is a chronic and pervasive source of psychological distress for patients and plays an important role in the rehabilitation of stroke survivors. Little is known about the level and correlates of uncertainty among patients in the acute phase of stroke.
The purposes of this study were to describe the uncertainty of patients in the acute phase of stroke and to explore characteristics of patients associated with that uncertainty.
A cross-sectional descriptive and correlational study was conducted with a convenience sample of 451 consecutive hospitalized acute stroke patients recruited from the neurology department of 2 general hospitals of China. Uncertainty was measured using Chinese versions of Mishel Uncertainty in Illness Scale for Adults on the fourth day of patients' admission.
The patients had moderately high Mishel Uncertainty in Illness Scale for Adults scores (mean [SD], 74.37 [9.22]) in the acute phase of stroke. A total of 95.2% and 2.9% of patients were in moderate and high levels of uncertainty, respectively. The mean (SD) score of ambiguity (3.05 [0.39]) was higher than that of complexity (2.88 [0.52]). Each of the following characteristics was independently associated with greater uncertainty: functional status (P = .000), suffering from other chronic diseases (P = .000), time since the first-ever stroke (P = .000), self-evaluated economic pressure (P = .000), family monthly income (P = .001), educational level (P = .006), and self-evaluated severity of disease (P = .000).
Patients experienced persistently, moderately high uncertainty in the acute phase of stroke. Ameliorating uncertainty should be an integral part of the rehabilitation program. Better understanding of uncertainty and its associated characteristics may help nurses identify patients at the highest risk who may benefit from targeted interventions.
不确定性是患者心理困扰的一个长期且普遍存在的根源，在中风幸存者的康复过程中起着重要作用。对于中风急性期患者的不确定性水平及其相关因素知之甚少。
本研究的目的是描述中风急性期患者的不确定性，并探讨与该不确定性相关的患者特征。
采用横断面描述性和相关性研究，从中国两家综合医院的神经内科连续招募了451例住院急性中风患者作为便利样本。在患者入院第四天，使用中文版成人疾病不确定感量表（Mishel Uncertainty in Illness Scale for Adults）测量不确定性。
中风急性期患者的成人疾病不确定感量表得分中等偏高（均值[标准差]，74.37[9.22]）。分别有95.2%和2.9%的患者处于中度和高度不确定水平。模糊性的平均（标准差）得分（3.05[0.39]）高于复杂性得分（2.88[0.52]）。以下每个特征都与更高的不确定性独立相关：功能状态（P = 0.000）、患有其他慢性病（P = 0.000）、首次中风后的时间（P = 0.000）、自我评估的经济压力（P = 0.000）、家庭月收入（P = 0.001）、教育水平（P = 0.006）和自我评估的疾病严重程度（P = 0.000）。
中风急性期患者持续经历中等偏高的不确定性。改善不确定性应成为康复计划的一个组成部分。更好地理解不确定性及其相关特征可能有助于护士识别那些可能从有针对性的干预中受益的高危患者。
