上海护理2026，Vol.26Issue(6)：46-52,7.DOI:10.3969/j.issn.1009-8399.2026.06.009
中青年脑卒中患者术后心理社会适应变化轨迹潜在类别及其对康复锻炼依从性的影响
Latent Classes of Postoperative Psychosocial Adjustment Trajectories and Their Impact on Rehabilita-tion Exercise Adherence in Young and Middle-Aged Stroke Patients
摘要
Abstract
Objective To explore the latent classes of postoperative psychosocial adjustment trajectories and their impact on autonomous rehabilitation behaviors in young and middle-aged stroke patients,aiming to iden-tify characteristics of different trajectory classes and provide theoretical evidence for developing staged,per-sonalized nursing interventions.Methods From October 2021 to October 2024,242 young and middle-aged stroke patients treated at Jiujiang No.1 People's Hospital were selected by convenience sampling.They were assessed for psychosocial adjustment levels using the Psychosocial Adjustment to Illness Scale-Self-Report(PAIS-SR)within 72 h postoperatively and at 1 month,3 months and 6 months postoperatively.A growth mix-ture model was applied to identify the optimal number of trajectory classes and name the classes.They were al-so assessed for rehabilitation exercise adherence,fatigue,pain,depression and rehabilitation motivation us-ing the Exercise Adherence Questionnaire(EAQ),Fatigue Severity Scale(FSS),Visual Analogue Scale(VAS),Hamilton Rating Scale for Depression(HAMD)and Stroke Rehabilitation Motivation Scale(SRMS).Their clinical data were collected using the General Information Questionnaire and the hospital's elec-tronic medical record system.Correlation analysis,univariate analysis and multivariate linear regression were conducted to analyze the independent factors influ-encing rehabilitation exercise adherence.Results Psychosocial adjustment trajectories of the 242 patients were categorized into three latent classes:resilient adjustment type(86 subjects,35.54%),fluctuating gradu-al decline(116 subjects,47.93%),and maladjustment(40 subjects,16.53%).Multivariate linear regression analysis showed that education level,postoperative psychosocial adjustment trajectory class,FSS score,HAMD score and SRMS score were independent factors influencing patients'rehabilitation exercise adherence(P<0.05 for all).Conclusion The postoperative psychosocial adjustment trajectories of young and middle-aged stroke patients exhibit distinct characteristics across classes.Educational level,postoperative psychoso-cial adjustment trajectory class,FSS score,HAMD score and SRMS score constitute a predictive framework for rehabilitation exercise adherence.This indicates that stratified interventions targeting individuals with dif-ferent adjustment trajectories are needed in clinical practice to enhance rehabilitation efficacy.关键词
中青年/脑卒中/心理社会适应/康复锻炼依从性/轨迹/影响因素Key words
Young and middle-aged/Stroke/Psychosocial adjustment/Rehabilitation exercise adherence/Trajectory/Influencing factor分类
医药卫生引用本文复制引用
张依,程芳,苏婉茜,洪佳莹..中青年脑卒中患者术后心理社会适应变化轨迹潜在类别及其对康复锻炼依从性的影响[J].上海护理,2026,26(6):46-52,7.基金项目
江西省卫生健康委科技计划项目(202211793). （202211793）
