神经内科护士对卒中后抑郁认知现状调查分析

doi:10.3969/j.issn.1673-5765.2023.10.016

摘要/Abstract

摘要： 目的分析神经内科护士对卒中后抑郁认知现状并分析其影响因素，为开展针对性卒中后抑郁培训及改善临床护理实践提供依据。
方法采用便利抽样法，选取全国7个地域神经护士为研究对象，使用自行设计的卒中后抑郁认知调查问卷进行调查，分析护士对卒中后抑郁认知现状及影响因素。
结果共纳入600名研究对象，不同性别、卒中护理工作年限、学历、职称、婚姻状况护士卒中后抑郁认知总分比较，差异无统计学意义。仅有25%的研究对象接受过卒中后抑郁相关培训，且接受过培训的护士认知程度远高于未接受过培训的护士（P＜0.001）。护士对卒中后抑郁诊断认知水平最低，对卒中后抑郁药物治疗认知不足（50.33%），对健康教育（90.33%）和心理干预（88%）两种护理干预策略认知度相对较高。
结论神经内科护士对卒中后抑郁认知不足，可能与培训机会少密切相关，应提高对护士卒中后抑郁培训力度，通过推动医疗、护理、康复、中医、精神心理等多学科协作，指导护士开展临床护理实践，提高卒中护理质量。

文章导读： 本研究对神经内科护士PSD认知现状进行调查分析，结果显示PSD认知水平有待提高，应加强培训力度，推动多学科合作，以提高护士知识掌握程度和实践能力，从而改善卒中护理质量。

关键词: 卒中后抑郁; 认知; 护士

Abstract: Objective To analyze the knowledge status of post-stroke depression in neurology nurses, and analyze its influencing factors so as to provide reference for clinical training on post-stroke depression and improve clinical nursing practice.
Methods The convenience sampling method was used to select nurses from 7 provinces and cities as the research objects. The self-designed questionnaire was conducted to investigate the knowledge status of post-stroke depression in neurology nurses and impacting factors.
Results A total of 600 nurses were selected. There was no significant difference in the total score of post-stroke depression knowledge status among nurses with gender, stroke nursing years, education, professional title and marital status. Only 25% of the participants received training in post-stroke depression, and the knowledge level of nurses who received training was significantly higher than that of nurses who did not receive training (P<0.001). The nurses had the lowest knowledge status of post-stroke depression diagnosis, insufficient cognition of drug treatment for post-stroke depression (50.33%), and high awareness of health education (90.33%) and psychological intervention (88%).
Conclusions The lack of knowledge of post-stroke depression in neurology nurses is closely related to the lack of training. In the future, manager should strengthen training of nurses on post-stroke depression, promote the collaboration of medical, nursing, rehabilitation, traditional Chinese medicine, psychiatry and other disciplines, to improve the quality of stroke nursing.

Key words: Post-stroke depression; Knowledge; Nurse

苗亚杰, 尹志科, 邓永梅. 神经内科护士对卒中后抑郁认知现状调查分析[J]. 中国卒中杂志, 2023, 18(10): 1209-1214.

MIAO Yajie, YIN Zhike, DENG Yongmei. Analysis on Knowledge of Post-stroke Depression among Neurology Nurses[J]. Chinese Journal of Stroke, 2023, 18(10): 1209-1214.

参考文献

[1] CAI W，MUELLER C，LI Y J，et al. Post stroke depression and risk of stroke recurrence and mortality：a systematic review and meta-analysis[J/OL]. Ageing Res Rev，2019，50：102-109[2023-06-15]. https://doi.org/10.1016/j.arr.2019.01.013.
[2] EZEMA C I，AKUSOBA P C，NWEKE M C，et al. Influence of post-stroke depression on functional independence in activities of daily living[J]. Ethiop J Health Sci，2019，29（1）：841-846.
[3] TOWFIGHI A，OVBIAGELE B，EL HUSSEINI N，et al. Poststroke depression：a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association[J/OL]. Stroke，2017，48（2）：e30-e43[2023-06-15]. https://doi.org/10.1161/STR.0000000000000113.
[4] GUO J L，WANG J J，SUN W，et al. The advances of post-stroke depression：2021 update[J]. J Neurol，2022，269（3）：1236-1249.
[5] HACKETT M L，PICKLES K. Part I：frequency of depression after stroke：an updated systematic review and meta-analysis of observational studies[J]. Int J Stroke，2014，9（8）：1017-1025.
[6] 李菊芳，罗勇，李云，等. 脑卒中后抑郁诊断及筛查工具研究进展[J]. 护理研究，2017，31（11）：1298-1300.
LI J F，LUO Y，LI Y，et al. Research progress on diagnosis and screening tools of post-stroke depression[J]. Nursing Research of China，2017，31（11）：1298-1300.
[7] 蔡卫新，张冉，张婷婷，等. 卒中领域护士的卒中专科护士培训需求分析[J]. 中国卒中杂志，2021，16（3）：314-320.
CAI W X，ZHANG R，ZHANG T T，et al. Analysis of requirements of stroke specialized nurses training[J]. Chin J Stroke，2021，16（3）：314-320.
[8] 郝雅丽，刘鹭. 卒中后抑郁护理的研究现状与干预方法[J]. 护理研究，2017，31（34）：4380-4383.
HAO Y L，LIU L. Research status and intervention method study of post-stroke depression nursing[J]. Chinese Nursing Research，2017，31（34）：4380-4383.
[9] 周元，王雪梅，王荣，等. 成人脑卒中后抑郁筛查与管理的最佳证据总结[J]. 护理研究，2021，35（4）：582-588.
ZHOU Y，WANG X M，WANG R，et al. Summary of the best evidence for screening and management of post-stroke depression in adults[J]. Chinese Nursing Research，2021，35（4）：582-588.
[10] 倪婷，刘美玲，员迎花，等. 脑卒中后抑郁症患病率及相关因素分析[J]. 中华现代护理杂志，2019，25（23）：2938-2941.
NI T，LIU M L，YUAN Y H，et al. Post-stroke depression and related factors analysis[J]. Chin J Mod Nurs，2019，25（23）：2938-2941.
[11] LIMAMPAI P，WONGSRITHEP W，KUPTNIRATSAIKUL V. Depression after stroke at 12-month follow-up：a multicenter study[J]. Int J Neurosci，2017，127（10）：887-892.
[12] FRANK D，GRUENBAUM B F，ZLOTNIK A，et al. Pathophysiology and current drug treatments for post-stroke depression：a review[J]. Int J Mol Sci，2022，23（23）：15114.
[13] 单亚维，张翠娣，陆海英，等. 脑卒中后抑郁发生相关因素分析[J]. 中国实用护理杂志，2016，32（26）：2026-2029.
SHAN Y W，ZHANG C D，LU H Y，et al. Factors influencing the incidence of post-stroke depression[J]. Chin J Prac Nurs，2016，32（26）：2026-2029.
[14] 倪琪琦，万昕瑞，沈娇妮，等. 脑卒中后抑郁患者非药物干预的最佳证据总结[J]. 中华现代护理杂志，2022，28（17）：2296-2302.
NI Q Q，WAN X R，SHEN J N，et al. Summary of the best evidence for nonpharmacological interventions in patients with post-stroke depression[J]. Chin J Mod Nurs，2022，28（17）：2296-2302.
[15] WANG H，PAN S C，XU Q W，et al. The effect of intensive family-centered health education on the awareness rate，diagnosis，and treatment of post-stroke depression in community families[J]. BMC Prim Care，2022，23（1）：282.
[16] LANCTOT K L，LINDSAY M P，SMITH E E，et al. Canadian stroke best practice recommendations：mood，cognition and fatigue following stroke，6th edition update 2019[J]. Int J Stroke，2020，15（6）：668-688.
[17] WANG S B，WANG Y Y，ZHANG Q E，et al. Cognitive behavioral therapy for post-stroke depression：A meta-analysis[J/OL]. J Affect Disord，2018，235：589-596[2023-06-15]. https://doi.org/10.1016/j.jad.2018.04.011.
[18] 李丽君，张宁，陈琦，等. 正念干预卒中后抑郁症状的meta分析[J]. 中国卒中杂志，2021，16（5）：502-507.
LI L J，ZHANG N，CHEN Q，et al. Mindfulness training on post-stroke depression：a meta analysis[J]. Chin J Stroke，2021，16（5）：502-507.
[19] LAM CHING W，LI H J，GUO J W，et al. Acupuncture for post-stroke depression：a systematic review and network meta-analysis[J]. BMC Psychiatry，2023，23（1）：314.
[20] HANG X Y，LI J J，ZHANG Y J，et al. Efficacy of frequently-used acupuncture methods for specific parts and conventional pharmaceutical interventions in treating post-stroke depression patients：a network meta-analysis[J/OL]. Complementary Ther Clin Pract，2021，45：101471[2023-06-15]. https://doi.org/10.1016/j.ctcp.2021.101471.