Acceptance Of Illness Status Quo And Influencing Factors In Young And Middle-aged Stroke Patients

Objective:In this research,a cross-sectional study was carried out to investigate the current status of the acceptance of illness amang young and middle-aged stroke patients;and the influencing factors of disease acceptance in young and middle-aged stroke patients were analyzed from five aspects based on the health ecological model,In addition,the structural equation model(SEM)was developed to investigate the interaction between the various factors,That would be useful in providing a scientific basis for formulating relevant intervention methods in the later period.Methods:In our study,a total of 250 young and middle-aged stroke patients were identified,who were hospitalized in 7 departments of encephalopathy,and acupuncture rehabilitation departments of a Ⅲ-a hospital in Hefei City from February 2022 to November 2022,by a convenient sampling method.During the survey of the questionnaire,the following scales were used,including a general information questionnaire,Acceptance Of Illness Scale(AIS),Social Support Rating Scale(SSRS),Stroke Stigma Scale(SSS),Stroke Self-Efficacy of Rehabilitation Questionnaire(SSEQ),and Self-Rating Depression Scale(SDS).Excel and SPSS23.0 software were used for the import and analysis of data.First of all,we used the independent sample t test and one-way ANOVA to perform a univariate analysis,which aims to analyze factors influencing acceptance of illness in these stroke patients.Then,we did a multivariate analysis using hierarchical linear regression.In addition,statistical methods,Pearson correlation analysis,were adopted to analyze the correlation between stigma,self-efficacy,social support,depression and disease acceptance in young and middle-aged stroke patients.Finally,in order to clarify the mechanism of each influencing factors,we established a structural equation model by Amos26.0.Results:1.The overal mean score of acceptance of illness in young and middle-aged stroke patients was 22.87±5.99,which was at a medium under level.There were 80 patients(32.0%)with low level of acceptance of illness,144 patients(57.6%)with medium level of acceptance of illness,and 26 patients(10.4%)with high level of acceptance of illness.2.Univariate analysis showed that residence,the number of children,degree of education,work status,monthly family income,medical insurance,type of disease,course of the disease,complication,frequency of onset,level of social support,level of stigma,self-efficacy and depression status had statistically significant effect on the level of disease acceptance in young and middle-aged stroke patients(P<0.05).Hierarchical linear regression analysis showed that residence,degree of education,work status,monthly family income,medical insurance,course of the disease,frequency of onset,level of social support,level of stigma,self-efficacy and depression status were the influencing factors of disease acceptance in young and middle-aged stroke patients(P<0.05).Finally,Model 5 can explain 68.1% of the total variation(F =145.957,P<0.001).3.Correlation analysis showed that acceptance of illness in young and middle-aged stroke patients was positively correlated with level of social support and self-efficacy(r=0.663,P<0.01;r=0.479,P<0.01),and negatively correlated with level of stigma and depression status(r=0.363,P<0.01;r=0.479,P<0.01).Social support was positively correlated with self-efficacy(r=0.764,P<0.01),and negatively correlated with level of stigma and depression status(r=-0.641,P<0.01;r=-0.323,P<0.01).Stigma was positively correlated with depression status(r=0.737,P<0.01),and negatively correlated with self-efficacy(r=-0.659,P < 0.01).Self-efficacy was negatively correlated with depression status(r=-0.457,P<0.01).4.The result of structural equation model showed that the final structural equation model was well fitted,and the model adaptation indexes were:X~2/df=2.148,AGFI=0.916,GFI=0.960,RMSEA=0.068,NFI=0.967,IFI=0.982,CFI=0.982,TLI=0.969.Path analysis showed that all four influencing factors that social support,stigma,self-efficacy and depression,have direct influence on disease acceptance(P<0.01),among which social support positively affected disease acceptance,and the direct,indirect and total effects were 0.225,0.438 and 0.663,respectively.Stigma negatively affected patients’ disease acceptance,and the direct,indirect and total effects were-0.217,-0.216 and-0.433,respectively.The direct,indirect and total effects of self-efficacy were 0.300,0.101 and 0.401,respectively.Depression negatively affected patients’ disease acceptance,and its total effect(direct effect)on patients was-0.293.Conclusion:1.The overall level of disease acceptance in young and middle-aged stroke patients is medium under,which needs to be improved.There are many influencing factors of disease acceptance in these stroke patients,including residence,degree of education,work status,monthly family income,medical insurance,course of the disease,frequency of onset,level of social support,level of stigma,self-efficacy and depression status.This suggests that in the future,when implementing interventions on disease acceptance of young and middle-aged stroke patients,medical staff should focus on those who live in rural areas,have low educational level,no job,no medical insurance,low family income,multiple episodes,low levels of self-efficacy and social support,and high levels of stigma and depression.2.The effective way to improve the disease acceptance of young and middle-aged stroke patients is to enhance patients’ social support scale,self-efficacy,and reduce patients’ stigma and depression.3.The health ecological model has a good explanatory effect on the influencing factors of acceptance of illness in these stroke patients,which can be used as a theoretical basis for related research on acceptance of illness in young and middle-aged stroke patients.