Study On Illness Acceptability And Its Intervention Effects In Patients With Stroke

Objective:To evaluate the status of illness acceptance of stroke patients,and to analyze the biological-psychosocial factors affecting the illness acceptability;To construct the intervention plan of the solution-focused brief therapy and verify the effect of intervention for stroke patients,to provide theoretical basis and practical guidance for early rehabilitation and nursing of stroke patients.Methods:This study was divided into two parts.The first part was a baseline survey.Using convenient sampling,total 180 patients with stroke who were hospitalized in rehabilitation Department of three first-class hospitals in Chengde City,Hebei Province from September 2019 to November 2020 were selected as the research object,and were investigated with Perceived Social Support Scale,Medical Coping Modes Questionnaire,Stroke Self-efficacy Questionnaire,the Cognitive Appraisal of Health Scale and Acceptance Illness Scale.To determine the status of illness acceptance in stroke patients,and analyze the biological-psychosocial factors affecting the illness acceptability.The second part was an intervention study.164 cases of patients with stroke were selected with informed consent.The patients were divided into experimental group(n=82 cases)and control group(n=82 cases)according to random number table method.The control group carried out routine nursing,the experimental group carried out solution-focused brief therapy psychological nursing intervention on the basis of control group.Perceived Social Support Scale,Medical Coping Modes Questionnaire,Stroke Self-efficacy Questionnaire,the Cognitive Appraisal of Health Scale and Acceptance Illness Scale were used to access the two groups before and after the intervention.SPSS23.0 statistical software was used for statistical analysis.Bilateral test was used,test level α=0.05.Results:1.The total score of illness acceptability was(19.99±5.21),perceived social support was(48.32±7.83).The scores of medical coping modes were as follows: confrontation(18.64±4.55),avoidance(18.40±4.56),resignation(12.01±2.79).The total score of rehabilitation self-efficacy was(63.80±16.33).The scores of the cognitive appraisal of health were as follows: threat(14.85±3.66),challenge(18.40±4.61),harm/loss(25.51±6.83),benign/irrelevant(11.33±3.36).2.There was no statistical significance in the scores of patients with different ages,education level,occupation,family monthly income,payment method,operation or not,and course of the disease(P>0.05),while there was statistical significance in the scores of patients with different genders,marital status,residence and disease types(P<0.05).3.In stroke patients,perceived social support,confrontation,rehabilitation self-efficacy,challenge and benign/irrelevant were positively correlated with illness acceptance(r=0.624,0.675,0.696,0.379,0.370,P<0.01),avoidance,resignation,threat and harm/loss were negatively correlated with illness acceptance(r=-0.647,-0.669,-0.435,-0.688,P<0.01).4.Perceived social support,resignation,rehabilitation self-efficacy,and harmful/lost were the main influencing factors of illness acceptance in stroke patients,which together accounted for 61.9% of the total variation.5.Before intervention,there was no statistical difference in the scores of illness acceptance between the experimental group and the control group(t=1.085,P=0.280).There were statistically significant differences in the scores of illness acceptance after intervention(t=4.900,P<0.001).6.Before intervention,there were no statistical differences in perceived social support,medical coping style,rehabilitation self-efficacy,cognitive appraisal of health between 2 groups(t=0.013～1.921,all P>0.05).There were statistically significant differences in perceived social support,medical coping style,rehabilitation self-efficacy,cognitive appraisal of health between the two groups(t=2.199～10.069,all P<0.05),after intervention.7.After intervention,the scores of illness acceptance in both groups were higher than before intervention.There were statistically significant differences in the scores of perceived social support,resignation,rehabilitation self-efficacy,threat and harm/loss in the control group before and after intervention(t=1.228～4.785,all P<0.05).There were statistically significant differences in scores of each scale in the experimental group(t=7.670～20.044,all P<0.001).Conclusion:1.Stroke patients have moderate or low levels of illness acceptance.2.Perceived social support,resignation,rehabilitation self-efficacy,and harmful/lost were the main influencing factors of illness acceptance in stroke patients.3.Solution-focused brief therapy is a feasible psychological nursing intervention measure,which can improve the patient’s illness acceptance level,perceived social support level and rehabilitation self-efficacy.Therefore,guiding patients to take a positive coping mode and increasing the positive cognitive appraisal is conductive to the patient’s physical and mental recovery.