中风幸存者心理应激反应的影响因素及诱发结果：一项系统综述
Contributing Factors and Induced Outcomes of Psychological Stress Response in Stroke Survivors: A Systematic Review.
作者信息
Zhang Song, Yuan Yuan, Zhuang Wenwen, Xiong Tianqing, Xu Yijun, Zhang Jingwen, Tao Chunhua, Liang Jingyan, Wang Yingge
机构信息
Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou, China.
School of Nursing and School of Public Health, Yangzhou University, Yangzhou, China.
出版信息
Front Neurol. 2022 Jun 22;13:843055. doi: 10.3389/fneur.2022.843055. eCollection 2022.
BACKGROUND
Remarkable evidence indicates that psychological stress is significantly associated with stroke. However, a uniform recommendation to identify and alleviate poststroke psychological stress responses and improve postmorbid outcomes is not currently available. Thus, this systematic review aimed to summarize the types of poststroke psychological stress, measurement tools, contributing factors, and outcomes.
METHODS
This systematic review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A literature search was conducted in PubMed, Web of Science, Embase, CNKI, WanFangData, and CQVIP from database inception to November 2021. Cross-sectional and longitudinal studies were included in this research. Quality assessment was performed based on the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.
RESULTS
Eighteen quantitative, peer-reviewed studies were included for analysis. Selected articles mainly investigated perceived stress and posttraumatic stress disorder after stroke. We classified the contributing factors into four categories: sociodemographic factors, clinical disease factors, psychological factors, and behavioral and lifestyle factors. The postmorbid outcomes were divided into three categories: clinical disease outcomes, psychological outcomes, and behavioral and quality of life outcomes.
CONCLUSIONS
Compared to common patients, stroke survivors with the following characteristics suffered an increased psychological stress response: younger age, the presence of caregivers, depression, unsuitable coping strategies, etc. Meanwhile, lower quality of life, worse drug compliance, worse functional independence, and more severe mental disorders were significantly associated with increased psychological stress symptoms. Further studies are required to provide more trustworthy and meaningful references for mitigating the damage caused by psychological stress after stroke.
背景
大量证据表明，心理压力与中风显著相关。然而，目前尚无统一的建议来识别和缓解中风后的心理应激反应并改善病后结局。因此，本系统评价旨在总结中风后心理压力的类型、测量工具、影响因素和结局。
方法
本系统评价按照系统评价和Meta分析的首选报告项目进行。从数据库建库至2021年11月，在PubMed、Web of Science、Embase、中国知网、万方数据和维普资讯中进行文献检索。本研究纳入横断面研究和纵向研究。基于美国国立卫生研究院（NIH）观察性队列和横断面研究质量评估工具进行质量评估。
结果
纳入18项经过同行评审的定量研究进行分析。所选文章主要调查了中风后的感知压力和创伤后应激障碍。我们将影响因素分为四类：社会人口学因素、临床疾病因素、心理因素以及行为和生活方式因素。病后结局分为三类：临床疾病结局、心理结局以及行为和生活质量结局。
结论
与普通患者相比，具有以下特征的中风幸存者心理应激反应增加：年龄较小、有照顾者、抑郁、应对策略不当等。同时，生活质量较低、药物依从性较差、功能独立性较差以及精神障碍较严重与心理应激症状增加显著相关。需要进一步研究，为减轻中风后心理压力造成的损害提供更可靠且有意义的参考。
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