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中华脑科疾病与康复杂志(电子版)

中华脑科疾病与康复杂志(电子版) ›› 2025, Vol. 15 ›› Issue (03) : 180 -186. doi: 10.3877/cma.j.issn.2095-123X.2025.03.007

临床研究

老年脑卒中患者健康素养、社会支持与卒中复发风险感知的关系及其影响因素研究
王永清†(), 马小花, 张晓玲, 张赛赛, 张娜丽   
  1. 030001　太原，山西医科大学第二医院神经内科
  • 收稿日期:2024-10-16 出版日期:2025-06-15
  • 通信作者: 王永清

Study of the relationship between health literacy, social support and perceived risk of stroke recurrence in elderly stroke patients and its influencing factors

Yongqing Wang†(), Xiaohua Ma, Xiaoling Zhang, Saisai Zhang, Nali Zhang   

  1. Department of Neurology, Second Hospital of Shanxi Medical University, Taiyuan 030001, China
  • Received:2024-10-16 Published:2025-06-15
  • Corresponding author: Yongqing Wang
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引用本文：

王永清, 马小花, 张晓玲, 张赛赛, 张娜丽. 老年脑卒中患者健康素养、社会支持与卒中复发风险感知的关系及其影响因素研究[J/OL]. 中华脑科疾病与康复杂志(电子版), 2025, 15(03): 180-186.

Yongqing Wang, Xiaohua Ma, Xiaoling Zhang, Saisai Zhang, Nali Zhang. Study of the relationship between health literacy, social support and perceived risk of stroke recurrence in elderly stroke patients and its influencing factors[J/OL]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2025, 15(03): 180-186.

目的

探讨老年脑卒中患者健康素养、社会支持与卒中复发风险感知的关系及其影响因素。

方法

采用便民抽样法选取山西医科大学第二医院神经内科自2022年1月至2023年10月收治的114例老年脑卒中患者作为研究对象进行调查。通过一般资料调查表、复发风险感知评估量表、健康素养量表、理解社会支持量表等收集临床资料，采用Pearson相关性分析法分析老年脑卒中患者复发风险感知与健康素养、社会支持的关系，采用单因素分析和多元线性回归分析法分析老年脑卒中患者复发风险感知的影响因素。

结果

老年脑卒中患者复发风险感知总分为（63.33±13.72）分，健康素养总分为（64.65±12.85）分，社会支持总分为（66.17±11.50）分。Pearson相关性分析结果显示，老年脑卒中患者复发疾病危险因素感知得分、复发行为危险因素感知得分、复发严重性感知得分及总得分与健康素养、社会支持量表得分均呈正相关（P<0.05）。单因素分析结果显示，不同文化程度、基本疾病种类、卒中发作次数的老年脑卒中患者的复发风险感知总分比较，差异均有统计学意义（P<0.05）。多元线性回归分析结果显示，卒中发作次数、健康素养量表得分是老年脑卒中患者复发风险感知的影响因素（P<0.05）。

结论

老年脑卒中患者复发风险感知、健康素养及社会支持均处于中等水平，且其影响因素涉及卒中发作次数及健康素养，建议医护人员为患者提供健康宣教知识外，还可利用多媒体资源为患者进行健康管理，以提高患者的复发风险感知水平。

关键词: 脑卒中, 老年, 健康素养, 社会支持, 复发风险感知
Objective

To investigate the relationship between health literacy, social support and perceived risk of stroke recurrence in elderly stroke patients and the factors influencing them.

Methods

One hundred and fourteen elderly stroke patients admitted to Neurology Department of Second Hospital of Shanxi Medical University from January 2022 to October 2023 were investigated by convenience sampling method, general information questionnaire, recurrence risk perception assessment scale, health literacy scale and understanding social support scale. Pearson correlation analysis was used to analyze the correlation between recurrence risk perception of elderly stroke patients and health literacy and social support, and single factor and multiple linear regression analysis were used to analyze the influencing factors of recurrence risk perception of elderly stroke patients.

Results

The total score of perceived risk of recurrence in patients with elderly stroke was (63.33±13.72), the total score of health literacy was (64.65±12.85), and the total score of social support was (66.17±11.50). The results of Pearson correlation analysis showed that the scores of perceived risk factors for recurrent diseases, perceived risk factors for recurrent behaviors, and severity of recurrence in patients with elderly stroke were positively correlated with the scores of health literacy and social support scales (P<0.05). The results of univariate analysis showed that there were statistically significant differences in the total score of recurrence risk perception among elderly stroke patients with different levels of education, types of underlying diseases, and frequency of stroke attacks (P<0.05). The results of multiple linear regression analysis showed that the number of stroke episodes and health literacy scale scores were the influencing factors for the perceived recurrence risk of elderly stroke patients (P<0.05).

Conclusions

Elderly patients with stroke recurrence risk perception, health literacy and social support were all at a moderately level, and their influencing factors involve the number of stroke episodes and health literacy, so it was recommended that healthcare professionals provide patients with health education knowledge in addition to health management using multimedia resources, in order to improve the level of patients' recurrence risk perception.

Key words: Stroke, Older adults, Health literacy, Social support, Recurrence risk perception
表1 114例老年脑卒中患者复发风险感知、健康素养及社会支持得分情况
Tab.1 Perception of relapse risk, health literacy and social support scores in 114 elderly stroke patients
项目 条目数 得分（分，mean±SD）
复发风险感知总分 17 63.33±13.72
复发疾病危险因素感知 4 15.79±3.12
复发行为危险因素感知 6 22.16±4.47
复发严重性感知 7 25.38±6.13
健康素养总分 20 64.65±12.85
基本知识与理念 6 23.05±4.15
健康生活行为方式 9 25.97±5.23
基本技能 5 15.63±3.47
社会支持总分 12 66.17±11.50
家庭内支持 4 23.41±4.15
家庭外支持 8 42.76±7.35
表2 114例老年脑卒中患者复发风险感知与健康素养、社会支持的相关性
Tab.2 Correlation between perceived risk of relapse and health literacy and social support in 114 elderly stroke patients
项目 健康素养量表得分 社会支持量表得分
r值 P值 r值 P值
复发风险感知总得分 0.519 0.035 0.486 0.027
复发疾病危险因素感知得分 0.487 0.027 0.493 0.028
复发行为危险因素感知得分 0.261 0.005 0.511 0.032
复发严重性感知得分 0.523 0.039 0.488 0.027
表3 114例老年脑卒中患者复发风险感知影响因素的单因素分析（分，mean±SD）
Tab.3 Univariate analysis of factors affecting the perceived risk of recurrence in 114 elderly stroke patients (score, mean±SD)
项目 例数 复发风险感知总分 t/F值 P值
性别     1.185 0.238
男 72 61.55±15.21    
女 42 62.73±14.98    
文化程度     4.520 0.013
初中及以下 56 60.23±13.13    
高中或中专 28 62.46±14.67    
大专及以上 30 69.72±15.10    
婚姻状况     0.580 0.561
未婚 2 74.16±10.26    
已婚 108 63.65±16.95    
丧偶或离异 4 58.49±12.56    
居住情况     1.374 0.172
与配偶子女居住 108 63.13±16.46    
独居 6 59.42±15.99    
饮酒史     1.143 0.225
有 43 64.13±14.12    
无 71 62.98±15.76    
吸烟史     1.475 0.143
有 55 62.68±14.11    
无 59 63.70±13.25    
基础疾病种类     10.083 <0.001
无 32 55.23±10.10    
1种 47 64.05±12.13    
≥2种 35 68.47±14.09    
卒中发作次数     20.351 <0.001
1次 68 56.83±10.01    
2次 35 68.54±11.27    
>2次 11 72.75±12.14    
收入     0.855 0.428
<1000元 18 59.68±18.46    
1000~3000元 27 62.15±17.66    
>3000元 69 64.79±14.17    
医疗支付方式     2.260 0.109
自费 5 51.89±10.54    
医保 73 63.44±11.98    
新农合 36 63.67±12.10    
表4 多元线性回归分析中自变量赋值方式
Tab.4 Assignment methods for independent variables in multiple linear regression analysis
自变量 赋值方式
文化程度 初中及以下=1，高中或中专=2，大专及以上=3
基础疾病种类 无=1，1=2，≥2=3
卒中发作次数 1=1，2=2，>2=3
健康素养量表得分 原值录入
社会支持量表得分 原值录入
表5 老年脑卒中患者复发风险感知影响因素的多元线性回归分析
Tab.5 Multivariate linear regression analysis of influencing factors of recurrence risk perception in elderly stroke patients
变量 回归系数 标准误 标准化回归系数 t值 P值 95%CI
常量 5.698 8.136   0.700 0.485 -10.249~21.645
文化程度 1.033 1.465 0.059 0.705 0.482 -1.838~3.904
基础疾病种类 0.327 0.554 0.048 0.590 0.556 -0.759~1.413
卒中发作次数 8.612 1.843 0.356 4.673 <0.001 5.000~12.224
健康素养量表得分 0.476 0.119 0.362 4.000 <0.001 0.243~0.709
社会支持量表得分 0.146 0.114 0.125 1.281 0.203 -0.077~0.369
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