国际老年医学杂志2026，Vol.47Issue(5)：613-618,6.DOI:10.3969/j.issn.1674-7593.2026.05.010
老年脑卒中患者心境状态变化轨迹及核心影响因素决策树分析
Analysis of mental state trajectories and core influencing factors using decision tree in elderly stroke patients
摘要
Abstract
Objective To explore the trajectories of mental state changes in elderly stroke patients and analyze the predic-tive factors for different trajectory subtypes,so as to provide a basis for psychological intervention.Methods A convenience sampling method was used to select 120 elderly stroke patients admitted to the Affiliated Brain Hospital of Nanjing Medical University from Janu-ary 2023 to June 2024.Assessments were conducted using a general information questionnaire and the Chinese version of the Brief pro-file of mood states(BPOMS)at five time points:baseline(at admission,T0),1 month(T1),3 months(T2),6 months(T3),and 12 months(T4).Growth mixture modeling(GMM)was employed to identify distinct latent trajectories of mental state changes,based on which patients were grouped,and a decision tree model was used to analyze the core influencing factors.Results The total BPOMS scores of the elderly stroke patients at the five time points were(58.42±12.36)scores,(52.18±11.94)scores,(47.65±10.87)scores,(43.21±9.76)scores,and(40.33±8.45)scores,respectively,showing statistically significant differences across time points(P<0.001).GMM identified two distinct mental state trajectories:trajectory 1(Rapid Improvement Group,63.33%)and traj-ectory 2(Persistent Poor Group,36.67%).The decision tree model indicated that hope level,social support rating scale score,hos-pital anxiety and depression scale-depression(HADS-D)score,and recurrent stroke was important predictive factors for the trajectory subtypes,with hope level being the most significant factor(importance:100%).Conclusion The mental state of elderly stroke pa-tients shows an overall improving trend over time,but significant group heterogeneity exists.Hope level is identified as the core predic-tor of mental state changes.关键词
老年脑卒中/心境状态/轨迹/决策树/希望/社会支持Key words
Elderly stroke/Mental state/Trajectory/Decision tree/Hope/Social support引用本文复制引用
胡庆,王静,向阳..老年脑卒中患者心境状态变化轨迹及核心影响因素决策树分析[J].国际老年医学杂志,2026,47(5):613-618,6.基金项目
江苏省卫生健康委科研项目(M2022065) （M2022065）
