■中风是中国人死亡的主要原因。老年中风幸存者通常有其他慢性疾病,不仅仅是肌肉骨骼因年龄而退化,还有中风和其他疾病可能带来的身体形象变化,使他们无法照顾好自己和依赖他人。依赖程度影响中风幸存者的康复进展,并显示出需要认识的动态变化。
■本研究调查了合并疾病的老年中风患者的依赖性变化轨迹,并分析了影响因素。
■扎根于慢性病轨迹框架(CITF),一项纵向研究于2023年2月至2023年10月进行,追踪了在广州两家三级医院收治的312例合并合并症的老年卒中患者.在入院第5天(T0)使用护理依赖量表评估护理依赖水平,在放电(T1)时,出院后1个月(T2),出院后3个月(T3)。生长混合模型用于识别轨迹类别,并采用单因素分析和多因素logistic回归方法探索与不同发育轨迹相关的因素。
■共拟合了四个发育轨迹,C1(高独立性-缓慢增加组,52.0%),C2(中度独立性-快速增加组,13.0%),C3(中度独立-缓慢增加组,25.0%),和C4(低独立性-增加和减少组,10.0%)。住院时间,居住地,社会支持水平,剩余功能损害,NIHSS得分,和BI指数独立影响轨迹类别。
■合并疾病的老年卒中患者的护理依赖性存在异质性。大多数患者逐渐减少依赖性,变得更加独立,但其他人仍然依赖很长一段时间。建议重点关注生活在农村地区的病人,社会支持低,有较高的入学NIHSS分数和残余功能损害,并为他们提供个性化的持续护理和康复服务,以减少护理依赖和护理负担,改善患者的生活质量。
UNASSIGNED: Stroke is the leading cause of death in
China. Older stroke survivors often have other chronic conditions, not only musculoskeletal deterioration due to age, but also changes in body image that can be brought on by stroke and other diseases, making them unable to take good care of themselves and dependent on others. The degree of
dependency affects the rehabilitation progress of stroke survivors and shows dynamic changes that need to be recognized.
UNASSIGNED: This study investigates the trajectory of
dependency changes in older stroke patients with comorbidities and analyze the influencing factors.
UNASSIGNED: Grounded in the Chronic Illness Trajectory Framework (CITF), a longitudinal study was conducted from February 2023 to October 2023, tracking 312 older stroke patients with comorbidities admitted to two tertiary hospitals in Guangzhou. Care
dependency levels were assessed using Care
Dependency Scale on admission day 5 (T0), at discharge (T1), 1 month post-discharge (T2), and 3 months post-discharge (T3). Growth Mixture Model were utilized to identify trajectory categories, and both univariate analysis and multivariate logistic regression methods were employed to explore factors associated with different developmental trajectories.
UNASSIGNED: A total of four developmental trajectories were fitted, C1 (high independence-slow increased group, 52.0%), C2 (moderate independence-rapid increased group, 13.0%), C3 (moderate independence-slow increased group, 25.0%), and C4 (low independence-increased and decreased group, 10.0%). Length of hospital stay, place of residence, level of social support, residual functional impairments, NIHSS score, and BI index independently influence the trajectory categories.
UNASSIGNED: There is heterogeneity in care dependency among older stroke patients with comorbidities. Most patients gradually reduce their
dependency and become more independent, but others remain dependent for an extended period of time. It is recommended to focus on patients who live in rural areas, have low social support, have high admission NIHSS scores and have residual functional impairment, and provide them with personalized continuity of care and rehabilitation services in order to reduce care dependency and the burden of care, and to improve patients\' quality of life.