Aims: To explore (a) resilience among patients over the first 6 months following a first ischaemic stroke; (b) factors associated with resilience at hospitalization, 1, 3, and 6 months postdischarge; (c) baseline predictors of resilience at 6 months postdischarge.
Design: a cohort study.
Methods: From February 2017-January 2018, 217 patients presenting at two hospitals with a first ischaemic stroke were recruited. Their resilience, medical coping styles, general self-efficacy, functional independency, socio-demographic, and clinical data were assessed while they were still in hospital (baseline) and at 1, 3, and 6 months after discharge.
Results: Resilience among stroke patients decreased significantly 1 month after hospital discharge and remained stable. Predictors of resilience were as follows: self-efficacy and resignation at baseline; number of children, functional independency, general self-efficacy, and resignation at 1 month; and religion, resignation, self-efficacy, confrontation at 3 months and 6 months. The baseline factors that predicted resilience at 6 months were income level, religion, stroke severity at discharge, self-efficacy, and resignation.
Conclusion: Stroke survivors experienced a significant decrease in resilience from hospitalization until 1-month postdischarge. Factors contributing to resilience after a stroke varied across time. Self-efficacy and coping styles were particularly important and contributed to long-term resilience.
Impact: Understanding resilience among stroke survivors is needed to inform the development of interventions to enhance the psychological recovery of survivors. The levels of resilience among stroke survivors were low compared with those in the normal older population. Nurses should provide greater psychological support during hospitalization to stroke survivors and especially to those with lower income, higher stroke severity at discharge, no religion, lower self-efficacy, or who use resignation as a coping strategy as those survivors may have lower resilience 6 months later. Future studies are needed to test interventions designed to change or modify stroke survivors' coping styles and promote self-efficacy, thereby enhancing higher resilience.
目的: 探讨(a)首发缺血性中风后患者前6个月的恢复能力;(b)出院后1、3和6个月再次住院时影响恢复能力相关因素;(c)出院后6个月恢复能力的基线预测指标。 设计: 定群研究。 方法: 从2017年2月至2018年1月,在两家医院共招募了217名首发缺血性中风患者。并对他们在住院期间(基线)和出院后1、3和6个月的恢复能力、医疗应对方式、一般自我效能感、功能独立性、社会人口学和临床数据进行评估。 结果: 中风患者出院后1个月恢复能力明显下降,并保持稳定。恢复能力的预测指标如下:基线时的自我效能感和辞职打算;1个月时的子女陪护人数、功能独立性、一般自我效能感和子女人数;3个月和6个月时的宗教信仰、辞职打算、自我效能感和对抗。预测6个月时的恢复能力的基线因素包括收入水平、宗教信仰、出院时中风严重程度、自我效能感和辞职打算。 结论: 从住院到出院后1个月,中风幸存者的恢复能力明显下降。影响中风后恢复能力的因素随时间而变化。自我效能感和应对方式尤其重要,对长期恢复能力有一定影响。 影响: 有必要了解中风幸存者的恢复能力,以便制定干预措施,提高幸存者的心理康复能力。与正常老年人相比,中风幸存者的恢复能力水平较低。护士应在中风幸存者住院期间为其提供更大的心理支持,尤其是那些收入较低、出院时中风严重程度较高、无宗教信仰、自我效能感较低的患者,或是那些将辞职作为应对策略的患者,因为此类幸存者在6个月后的恢复能力可能较低。 未来需要进行进一步的研究,以对旨在改变中风幸存者应对方式并提高自我效能感的干预措施进行检验,从而提高恢复能力。.
Keywords: coping styles; nursing; resilience; self-efficacy; stroke.
© 2019 John Wiley & Sons Ltd.