脑卒中偏瘫患者运动恐惧潜在剖面分析及影响因素研究

doi:10.3761/j.issn.1672-9234.2025.10.019

摘要/Abstract

摘要：

目的分析脑卒中偏瘫患者运动恐惧的潜在剖面及其影响因素。方法采用便利抽样法，选取2024年6月—2025年1月入住于河北省某三级甲等综合医院神经内科的247例脑卒中偏瘫患者作为调查对象，使用一般资料调查表、中文版坦帕运动恐惧量表、运动锻炼自我效能感量表、领悟社会支持量表及感知运动障碍量表对其进行调查。采用潜在剖面分析及多分类Logistic回归（向后去除）分析脑卒中偏瘫患者运动恐惧潜在剖面及其影响因素。结果 247例脑卒中偏瘫患者中，170例（68.8%）存在运动恐惧。脑卒中偏瘫患者运动恐惧可分为自主调节-运动适应组（38.5%）、疼痛主导-运动谨慎组（35.6%）、受伤敏感-运动回避组（25.9%）3个潜在剖面。相较于自主调节-运动适应组，近一年无跌倒史者、领悟社会支持得分高者更不易进入其他两组，入院时疼痛评分高者更易进入疼痛主导-运动谨慎组，运动锻炼自我效能得分高者更不易进入疼痛主导-运动谨慎组，感知运动障碍得分高者更易进入其他两组（P<0.05）。结论脑卒中偏瘫患者运动恐惧发生率较高，且存在群体异质性。医护人员应根据不同类别人群的特征及影响因素进行精准化干预，以降低脑卒中偏瘫患者运动恐惧水平，提升其运动治疗效果。

关键词: 脑卒中, 偏瘫, 运动恐惧, 潜在剖面分析, 影响因素分析

Abstract:

Objective To analyze the potential profile of kinesiophobia in stroke patients with hemiplegia and the influencing factors of different profile categories. Methods From June 2024 to January 2025，convenience sampling was used to select 247 stroke patients with hemiplegia in the Neurology Department of a Class Ⅲ Grade A hospital in Hebei Province as the participants. The general information questionnaire，Tampa Scale for Kinesiophobia，Exercise Self-Efficacy Scale，Perceived Social Support Scale，and Exercise Barriers Scale were used to investigate. Latent profile analysis and multiple Logistic regression were used to analyze the latent profile of kinesiophobia and its influencing factors in stroke patients with hemiplegia. Results Among the 247 stroke patients with hemiplegia，170 cases（68.8%） had kinesiophobia. The results of latent profile analysis showed that the kinesiophobia of stroke patients could be divided into three latent categories：autonomous regulation - exercise adaptation group（C1，38.5%），pain dominated-exercise caution group（C2，35.6%），and injury sensitivity - exercise avoidance group（C3，25.9%）. Compared with C1，patients without a history of falls in the past year and those with higher scores of perceived social support were less likely to be classified into C2 and C3；patients with higher pain scores at admission were more likely to be classified into C2；patients with higher scores of exercise self-efficacy were less likely to be classified into C2； patients with higher scores of exercise barriers were more likely to be classified into C2 and C3（P<0.05）. Conclusion The incidence of kinesiophobia in stroke patients with hemiplegia is high，and there is heterogeneity. Medical staff should carry out precise interventions according to the characteristics and influencing factors of different groups to reduce the level of kinesiophobia in stroke patients with hemiplegia and improve the effect of exercise therapy.

Key words: Stroke, Hemiplegia, Kinesiophobia, Latent profile analysis, Root cause analysis

孙仪泽, 孙程林, 张赛雅, 李萍, 张丽华. 脑卒中偏瘫患者运动恐惧潜在剖面分析及影响因素研究[J]. 中华护理教育, 2025, 22(10): 1273-1280.

SUN Yize, SUN Chenglin, ZHANG Saiya, LI Ping, ZHANG Lihua. Potential profile analysis and influencing factors of kinesiophobia in stroke patients with hemiplegia[J]. Chinese Journal of Nursing Education, 2025, 22(10): 1273-1280.

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