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中风后社会和心理因素与认知障碍的关系:一项前瞻性研究。

The relationship between social and psychological factors with cognitive impairment after stroke: a prospective study.

作者信息

Li Yao, Tang Aijie, Ge Lili, Zhang Lin, Chen Ling, Xu Yuhua, Wang Li, Zhu Xiaoping, Wu Qian

机构信息

Department of Nursing, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.

School of Nursing and Health, Henan University, Henan, Kaifeng, China.

出版信息

Front Psychiatry. 2024 Jun 26;15:1403027. doi: 10.3389/fpsyt.2024.1403027. eCollection 2024.

Abstract

OBJECTIVES

To investigate the association between social and psychological factors and the risk of cognitive impairment following acute ischemic stroke.

MATERIALS AND METHODS

A prospective study was conducted at Shanghai Tenth People's Hospital from June 2021 to July 2022. The study focused on social and psychological factors, which were assessed using the Social Support Rating Scale (SSRS), Self-Perceived Burden Scale (SPBS), and Hamilton Depression Scale (HAMD) within 3 days after admission to the hospital. Cognitive function was evaluated using the Montreal Cognitive Assessment at 3 months post-stroke. Logistic hierarchical regression models were used to examine the association between these three indicators and cognitive impairment following a stroke.

RESULTS

Among these patients, cognitive function was assessed in 211 cases at the 3-month follow-up after the initial stroke event. At 3 months post-stroke, 118(55.9%) of the participants experienced cognitive impairment, while 93(44.1%) did not. The scores on the SPBS and HAMD showed significant associations with cognitive impairment at 3 months after stroke. The scores of SPBS [scores: 3039 vs.<20 points, odds ratio (OR)=2.993 (1.135-7.896); scores: ≥40 vs.<20points, OR=7.382 (1.117-48.799); =0.043] and the HAMD [scores: >7 vs.≤7 points, OR=3.287(1.3627.936); =0.008]. There were no significant associations observed between SSRS and PSCI.

CONCLUSION

Early screening for depressive symptoms and focusing on self-perceived burden can be beneficial for decision support for clinicians and improve cognitive function recovery at the 3-month mark post-stroke.

摘要

目的

探讨社会心理因素与急性缺血性卒中后认知障碍风险之间的关联。

材料与方法

于2021年6月至2022年7月在上海第十人民医院进行了一项前瞻性研究。该研究聚焦于社会心理因素,在患者入院后3天内使用社会支持评定量表(SSRS)、自我感知负担量表(SPBS)和汉密尔顿抑郁量表(HAMD)对其进行评估。在卒中后3个月使用蒙特利尔认知评估量表对认知功能进行评估。采用逻辑分层回归模型检验这三个指标与卒中后认知障碍之间的关联。

结果

在这些患者中,211例在首次卒中事件后3个月随访时进行了认知功能评估。卒中后3个月,118例(55.9%)参与者出现认知障碍,93例(44.1%)未出现。SPBS和HAMD评分与卒中后3个月的认知障碍存在显著关联。SPBS评分[评分:3039分与<20分,比值比(OR)=2.993(1.1357.896);评分:≥40分与<20分,OR=7.382(1.11748.799);P=0.043]以及HAMD评分[评分:>7分与≤七分,OR=3.287(1.3627.936);P=0.008]。未观察到SSRS与PSCI之间存在显著关联。

结论

早期筛查抑郁症状并关注自我感知负担,可能有助于临床医生进行决策支持,并改善卒中后3个月时的认知功能恢复。

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