摘要目的 探讨脑卒中患者自我管理行为在神经功能缺损与健康状况之间的中介作用.方法 选取2015年3~6月在神经内科治疗的100例脑卒中患者,出院1年后,应用卒中自我管理行为量表(SSMBS)、神经功能缺损程度评分(SSS)和自测健康评定量表(SRHMS)进行问卷调查,运用SPSS 13.0和AMOS 7.0软件,采用逐步回归分析和Bootstrap程序进行数据统计分析.结果 100例脑卒中患者SSS总分为(13.38±5.29)分,SSMBS总分为(162.59±21.43)分,SRHMS总分为(278.13±51.48)分.双变量相关分析显示,自我管理行为、神经功能缺损和自测健康两两之间均存在相关性(r=-0.735,-0.568,0.693,P<0.01).中介效应检验显示,自我管理行为在神经功能缺损与健康状况间的中介效应为0.137,占总效应的24.1%.Bootstrap检验结果 显示,自我管理行为直接中介效应95%的置信区间为(0.066,0.208).结论 脑卒中患者自我管理行为在神经功能缺损和健康状况之间具有中介作用,是神经功能缺损和健康状况的预测因素,医务工作者应加强对诸如脑卒中等慢性病患者的健康自我管理行为干预.

abstractsObjective To explore the mediating effect of self-management behavior between nervous functional defects and health condition in patients with stroke.Methods A total of 100 patients with stroke chosen in Jianhu hospital affiliated to Nantong University from March to June 2015 were investigated using SSMBS,SSS and SRHMS through questionnaires after they left hospital for one year.The data was analyzed by stepwise regression analysis and Bootstrap procedure via SPSS13.0 and AMOS7.0.Results The total scores of SSS,SSMBS and SRHMS were (13.38±5.29),(162.59±21.43) and (278.13±51.48),respectively.Bivariate correlation analysis showed that there were correlations among self-management behavior,neurological impairment and self-rating health (r=-0.735,-0.568,0.693,P<0.01).The value of the mediating effect of self-management behavior was 0.137,accounting for 24.1% of the total effect.Bootstrap test showed 95% confidence interval of the direct mediating effect of self-management behavior was (0.006,0.208).Conclusions elf-management behavior has stronger mediating effect between nervous functional defects and health condition,it is a predictive factor of nervous functional defects and health condition.Medical workers should enhance the intervention of health self-management behavior for the patients with chronic diseases such as stroke.