The development trajectory and influencing factors of self compassion in elderly first stroke patients with semi disability based on the latent category growth model
10.3760/cma.j.cn211501-20240306-00504
- VernacularTitle:基于潜类别增长模型研究首发脑卒中半失能老年患者自我同情发展轨迹及影响因素分析
- Author:
Lijun HE
1
;
Weicheng LI
;
Zhong GAO
Author Information
1. 三亚中心医院（海南省第三人民医院）康复医学科，三亚 572000
- Keywords:
Stroke;
Self-compassion;
Trajectory;
Influencing factors;
Latent class analysis;
Semi-disability
- From:
Chinese Journal of Practical Nursing
2024;40(33):2569-2577
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the development trajectory and influencing factors of self compassion in elderly patients with first stroke hemiplegia, in order to provide a theoretical basis for adopting more targeted intervention measures at different stages and early identification of elderly stroke hemiplegia patients with sustained low self compassion.Methods:This was a prospective longitudinal study. Convenience sampling method was used to select 247 elderly patients with first-episode stroke admitted to Sanya Central Hospital (Hainan Third People′s Hospital) from January to December 2022 and who were assessed as semi-disabled (Barthel index was 40-99 ) before discharge. The baseline data of patients were collected by general information questionnaire, self-compassion scale, simplified fear of disease progression scale and social support rating scale. The self-compassion level of patients was evaluated before discharge, 1 month after discharge, 3 months after discharge and 6 months after discharge.The latent class growth model (LCGM) was used to identify the development trajectory of self-compassion, and multivariate Logistic regression was used to analyze the predictors of different development trajectory categories.Results:Ultimately, 219 patients completed the entire investigation and follow-up. There were 132 males and 87 females, aged (69.74 ± 4.05) years old. The self-compassion level of patients before discharge, 1 month after discharge, 3 months after discharge and 6 months after discharge were (72.37 ± 11.53), (74.65 ± 13.26), (76.84 ± 12.11), (79.45 ± 13.64) points, and there were positive correlation between scores ( r values were 0.29-0.55, all P<0.05). Three different trajectory change categories were identified by LCGM, namely high-level stable group (29%,63/219), low-level delayed decline group (23%, 51/219), and medium-level elevated group (48%, 105/219).Multivariate Logistic regression analysis showed that per capita monthly income<2 000 yuan ( OR=2.857, 95% CI 1.093-7.464, P<0.05), high comorbidities ( OR=5.625, 95% CI 1.971-16.051, P<0.01), high fear of disease progression ( OR=1.167, 95% CI 1.080-1.261, P<0.01), and low social support ( OR=00.763, 95% CI 0.595-0.979, P<0.05) were more likely to enter the low-level delayed decline group, and high school education( OR=4.429, 95% CI 1.479-13.265, P<0.01) and high social support ( OR=1.120, 95% CI 1.043-1.202, P<0.01) were more likely to enter the middle-level rise group. Conclusions:The development trend of self-compassion in elderly stroke patients with semi-disability can be divided into three different trajectories: high-level stable group, low-level delayed decline group and medium-level elevated group. Low income level, more comorbidities and fear of disease progression are not conducive to the development of self-compassion after discharge, while high education level and social support are conducive to the improvement of self-compassion after discharge. Medical staff can formulate targeted intervention programs to improve patients′ self-compassion based on the above influencing factors.
