心理及社会因素对脑卒中后焦虑的影响：情绪调节策略、 应对方式、社会支持的调节作用
文献类型：学位论文
| 作者 | 吕敏 |
| 答辩日期 | 2020-07 |
| 文献子类 | 硕士 |
| 授予单位 | 中国科学院心理研究所 |
| 授予地点 | 中国科学院心理研究所 |
| 其他责任者 | 李雪冰 |
| 关键词 | 脑卒中 情绪障碍 焦虑 心理因素 社会因素 |
| 学位名称 | 理学硕士（同等学力硕士） |
| 学位专业 | 健康心理学 |
| 其他题名 | Psychological and social effects on post-stroke anxiety: The regulating effects of emotion regulation strategies, coping style and social support |
| 中文摘要 | As a world-wide challenge, the stroke is one of the top priority research for improving the public health. Among several negative effect of stroke, post-stroke anxiety is one of the most important topics since it continuously aggravates the condition of patient.The post-stroke anxiety, as a common and continuous emotional disorder, has extremely negative effects on the prognosis and the living ability of patients, as well it costs a large amount of medical resources.However, it is commonly ignored by clinic although its high morbidity. There also is rare research focused on the effects of post-stroke anxiety.In this research, the post-stroke anxiety were investigated based on the epidemiology. Furthermore, the regulating effects of psychological and social aspects on post-stroke anxiety were determined.Both interviewing method and questionnaire survey were utilized to medically assess 166 continuous cases in total. All the cases were the patients who firstly suffered ischemic stroke.The Hamilton Anxiety Rating Scale (HARS) was used to individually assess the anxiety for each case.Note that the timeline for two assessments of each patient were took within two weeks after the stroke and then investigated at one month later.Meanwhile, these cases were compared with the health samples. Each comparative case, who matched the objective case with multiple factors, including gender, age, education level and living area, was similarly medical assessed and questionnaire surveyed, as well the HARS for rating the severity of anxiety. Moreover,both Pearson correlation coefficient and hierarchical regression analysis were utilized to build a statistical model in this research.Based on the results determined in this research, it is found that the morbidity of post-stroke anxiety at acute stage and restoration stage is much higher than comparative cases.There was a significant correlation between the HARS of post-stroke anxiety at acute stage and the severity of stroke, neuroticism, positive coping style, cognitive reappraisal emotion regulation strategies, social support utilization, and economic level.Further, the regulating effects on post-stroke anxiety have been obtained from four factors, including neuroticism, positive coping style, cognitive reappraisal emotion regulating strategies and social supporting, as well these four factor also have regulating effects on decreasing the severity of stroke.However, none influence from the severity of stroke on post-stroke anxiety has been observed.Moreover,it is determined that the cognitive reappraisal emotion regulating strategies has prediction function on the anxiety at restoration stage.Overall, it can be seen that the morbidity of anxiety for patients suffered stroke is significantly higher than health people, as well such morbidity lasts high value in a relative long period.It is highly recommended to improve recognition, screening and intervening of post-stroke anxiety, which can effectively promote the recovery and the prognosis.Furthermore, four factors which have regulating effects on post-stroke anxiety are obtained, including neuroticism, positive coping style, cognitive reappraisal emotion regulating strategies and social supporting, as well the cognitive reappraisal emotion regulating strategies has predictive effects on the anxiety at restoration stage.It suggests that these psychological and social factors should be considered into the psychological treatment program in future since they are easier to be achieved by patients.The positive coping style and the cognitive reappraisal emotion regulating strategies are highlighted based on results, as well the social supporting should be used to benefit the patients with better mental feelings. . Once achieves the emotion regulating, the patients perform more positive in physical rehabilitations with better participations. Thus, better treatments can be achieved to improve both psychological and physical conditions of patients. Not only suffers less from illness, but also costs less from social resources. |
| 英文摘要 | 脑卒中是世界性的重大公共卫生问题，脑卒中后焦虑被认为是卒中后严重的综合征之一。脑卒中后焦虑是常见且持续的情绪障碍，严重影响脑卒中个体预后及生活能力，消耗大量医疗资源。脑卒中后焦虑患病率高，但被临床普遍忽略，国内外相关研究缺乏。本研究对脑卒中后焦虑进行流行病学研究，进而探讨心理及社会因素对脑卒中后焦虑的调节作用。在心理因素上，我们重点关注个体的人格特质、应对方式及情绪调节策略对脑卒中后焦虑的影响；在社会因素上，我们重点考察家庭经济水平和社会支持对脑卒中后焦虑的影响。本研究采用访谈法及问卷调查法对166例连续入住综合医院神经内科病房的首次急性缺血性脑卒中患者进行医学评估及问卷测量，使用汉密尔顿焦虑量表分别对焦虑症状进行评估，调查时间分别在卒中后2周内和卒中后1月。同时将166例在性别、年龄、教育程度方面匹配的本地区社区健康人群设为对照组，对一般情况及焦虑症状进行评估，调查问卷及量表同脑卒中组。采用Pearson相关分析和分层回归分析等方法进行统计学分析。结果发现，脑卒中急性期和恢复期的焦虑患病率都远高于健康对照组的焦虑患病率；脑卒中急性期焦虑评分与卒中严重程度、神经质、积极应对方式、认知重评情绪调节策略、社会支持利用度、及经济水平有显著相关；神经质、积极应对方式、认知重评情绪调节策略、及社会支持利用度在卒中严重程度与焦虑之间起到了调节作用，经济水平在卒中严重程度与焦虑间没有调节作用；进一步分析发现，认知重评情绪调节策略对恢复期焦虑有预测作用。 综上所述，本文研究结果表明，相较普通人群焦虑，脑卒中后焦虑患病率明显升高，且在脑卒中后一段时间持续偏高，应关注对卒中后焦虑障碍的识别、筛查和干预，提高康复效率，改善预后；神经质、积极应对方式、认知重评情绪调节策略、社会支持利用度在卒中严重程度和焦虑之间起调节作用，认知重评情绪调节策略对脑卒中恢复期焦虑有预测作用。这些可控可变的心理及社会因素为未来的心理治疗方案提供了方向和空间。增加积极的应对方式和情绪调节策略，鼓励患者利用社会资源，改善心理体验，积极主动有效的配合躯体功能恢复，全面改善患者身心预后，提高生活质量，减轻家庭社会负担。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/41552]  |
| 专题 | 心理研究所_健康与遗传心理学研究室 |
| 推荐引用方式 GB/T 7714 | 吕敏. 心理及社会因素对脑卒中后焦虑的影响：情绪调节策略、 应对方式、社会支持的调节作用[D]. 中国科学院心理研究所. 中国科学院心理研究所. 2020. |
入库方式： OAI收割
来源：心理研究所
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