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基于脑卒中筛查的高危人群对脑卒中认知及慢性疾病管理依从性的研究

Stroke related Knowledge and Chronic Disease Management Compliance of Patients with High Risk of Stroke based on the Screening of High risk Population

DOI：

中文关键词: 脑卒中认知慢性疾病管理依从性

英文关键词:Stroke Knowledge Chronic disease anagement Compliance

基金项目:2013年甘肃省卫生行业科研计划管理项目（编号：GWGL2013-38）

作者	单位
宋霞¹ 杨飞¹ 韦亚洁² 杨永清² 邱雯¹	兰州大学第二医院 1.药学部临床药学科；2.脑卒中防治研究中心兰州 730030

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中文摘要:

摘要目的：了解脑卒中高危人群对脑卒中相关知识的认知情况及其对脑卒中慢性疾病管理的防治态度、用药需求及服药依从性，以期为脑卒中的有效预防及干预提供数据支持。方法：采用自制调查问卷，以面对面的方式，对426例于2013~2015年在兰州大学第二医院进行筛查的脑卒中高危人群进行调查，按照性别、年龄、文化水平三个因素分层，分别评价调查对象对脑卒中认知及慢性疾病管理依从性的情况。结果：调查对象对脑卒中危险因素的选择上排名前三的依次为高血压（81.69%）、血脂异常（50.23%）、心脏病（42.49%）。脑卒中警示症状报告最多的是偏侧肢体发麻（62.91%）与头晕头痛（60.09%），调查对象对单个卒中警示症状的识别比例为29.11%~62.91%，其中，88.73%能报告≥1个警示症状，20.66%能报告≥5个警示症状，调查对象均不能说出全部7个警示症状。应对脑卒中风险的态度上，较高比例（33.10%）的调查对象选择积极应对风险；28.40%想改变现状，需要医务人员指导；25.59%愿意维持现状；12.91%难以坚持预防措施。调查对象选择依从的健康管理方式最多的是调节饮食结构（73.47%），其次是加强锻炼（63.62%）。在服药指导的需求上，67.61%的调查对象明确表示需要医护人员的服药指导，按时服药及按剂量服药依从性上选择完全做到与基本做到的比例基本相近。对于长期服药的依从性，53.05%的调查对象表示基本做到，37.32%可以完全做到，剩余9.62%依从性较差，年龄及文化程度对此均有显著影响（P<0.05)。 结论：脑卒中高危人群对脑卒中相关知识的知晓率仍较低，防治态度不够积极，服药指导需求高以及依从性差，总体上还需加强健康教育及用药干预。

英文摘要:

ABSTRACT Objective:To investigate the stroke related knowledge, attitude, medication needs and compliance of patients with high risk of stroke, so as to provide date support for the effective prevention and intervention of stroke. Methods:From 2013 to 2015, using self designed questionnaire, the trained pharmacist conducted the face to face investigation among 426 patients with high risk for stroke in Lanzhou university second hospital. Cognitive of stroke and chronic disease management compliance in high risk groups were evaluated respectively according to the stratification of gender, age and cultural level. Results: The awareness rate of stroke risk factors in the first three cases were hypertension (81.69%), dyslipidemia (50.23%), and heart disease (42.49%). The most reported stroke warning symptoms were side limb numbness (62.91%) and with dizziness and headache (60.09%). The proportion of the recognition rate of single stroke warning symptoms was between 29.11% to 62.91%. 88.73% patients can report ≥1 stroke warning sign, 20.66% patients can report ≥5 stroke warning sign, and no one can say the all seven warning sign. In the attitude of high risk groups to stroke risk, a higher proportion of the population (33.10%) chose to respond positively, 28.40% want to change the status quo and need help from medical staff, 25.59% willing to maintain the recent situation, 12.91% can’t adhere to preventive measures. The health management approach high risk patients choose to follow was adjusting the diet (73.47%), followed by intensive exercise (63.62%). In the demand for medication guidance, 67.61% clearly indicated the need for medication guidance. The choice proportion of on time medication and dosage medication is basically similar. For compliance with long term medication, 53.05% of population were basically complied, 37.32% can do it completely, and the remaining 9.62% had poor compliance. Age and education level had significant effect on it (P<0.05). Conclusion:The awareness rate of stroke related knowledge was still low in stroke patients at high risk, prevention attitude is not positive enough, the demand for medication guidance was high and with poor compliance, so we need to strengthen health education and drug intervention.

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