Hu Ruidan, Wang Xiaoyan, Liu Zhihong, Hou Jiakun, Liu Yangyang, Tu Jinyi, Jia Miao, Liu Yue, Zhou Hongzhen
Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
School of Nursing, Southern Medical University, Guangzhou, Guangdong, China.
Top Stroke Rehabil. 2022 Jan;29(1):16-29. doi: 10.1080/10749357.2020.1864965. Epub 2020 Dec 28.
With the development of positive psychology, several studies show that positive and negative emotions are not always opposing. Understanding how positive and negative emotions correlate and the factors contributing to resilience in stroke survivors requires further research.
To identify the patterns and correlations of stigma, depression, and posttraumatic growth (PTG) among stroke survivors.
Stroke-related stigma, depression, PTG, and neurological status were evaluated at 1-month and 3 months post-stroke using the Stroke Stigma Scale (SSS), Patient Health Questionnaire-9 (PHQ-9), Chinese version of the Posttraumatic Growth Inventory (C-PTGI), modified Rankin Scale (mRS), and Social Support Rating Scale (SSRS). The paired -test, nonparametric test, and Spearman's correlation test were used to analyze differences and relationships between results at the two time points.
At 3 months compared to 1-month post-stroke, we found significant reductions in mRS and stigma scores, and an increase in PTGI scores, while the PHQ-9 scores reduced non-significantly. SSS, PHQ-9, and mRS scores were positively correlated with each other at time1 (all < .01), and all showed no significant relationships with PTGI scores (all > .05). Social support scores were negatively correlated with stigma ( < .01), PHQ-9 ( < .01), and PTGI scores ( > .05) at 3 months.
Stroke-related stigma is strongly associated with depression while neither of them has significant relationships with PTG during the early stage of survivors' rehabilitation in our study. Neurological impairment is a risk factor for negative emotions and increasing individualized support may reduce stigma, depression, and promote PTG in the long term.
随着积极心理学的发展，多项研究表明，积极情绪和消极情绪并非总是相互对立的。了解积极情绪和消极情绪之间的关联以及有助于中风幸存者恢复力的因素，需要进一步研究。
确定中风幸存者中耻辱感、抑郁和创伤后成长（PTG）的模式及相关性。
在中风后1个月和3个月时，使用中风耻辱量表（SSS）、患者健康问卷-9（PHQ-9）、中文版创伤后成长量表（C-PTGI）、改良Rankin量表（mRS）和社会支持评定量表（SSRS），对与中风相关的耻辱感、抑郁、PTG和神经功能状态进行评估。采用配对t检验、非参数检验和Spearman相关性检验，分析两个时间点结果之间的差异和关系。
与中风后1个月相比，在3个月时，我们发现mRS和耻辱感得分显著降低，PTGI得分增加，而PHQ-9得分无显著降低。在时间1时，SSS、PHQ-9和mRS得分彼此呈正相关（均P<0.01），且均与PTGI得分无显著关系（均P>0.05）。在3个月时，社会支持得分与耻辱感（P<0.01）、PHQ-9（P<0.01）呈负相关，与PTGI得分无显著关系（P>0.05）。
在我们的研究中，中风幸存者康复早期，与中风相关的耻辱感与抑郁密切相关，而两者均与PTG无显著关系。神经功能损害是负面情绪的一个危险因素，增加个性化支持可能会长期减少耻辱感、抑郁，并促进PTG。
