急性脑梗死患者溶栓治疗后自我效能感调查及影响因素分析

doi:10.3761/j.issn.2096-7446.2026.10.004

摘要/Abstract

摘要：

目的探究急性脑梗死（acute cerebral infarction，ACI）患者静脉溶栓治疗后的自我效能感水平及其影响因素，为针对性制订心理干预与康复支持策略、提升患者康复信心、促进神经功能恢复提供依据。方法采用连续抽样法，选取2023年1月至2025年1月南京市某三级甲等医院300例接受静脉溶栓治疗的ACI患者为研究对象，于溶栓后1个月使用自我效能感量表进行评估，根据得分将患者分为自我效能感良好组和自我效能感低下组，使用单因素和多因素Logistic回归分析影响ACI患者静脉溶栓后自我效能感低下的相关因素。结果 300例ACI患者溶栓后1个月总体自我效能感得分为（25.47±5.61）分，237例（79.00%）自我效能感良好，63例（21.00%）自我效能感低下。与自我效能感良好组相比，自我效能感低下组患者美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）评分、消极应对评分、焦虑情绪评分及血管再通不良占比更高，社会支持评分更低（P<0.05）。多因素Logistic回归显示，NIHSS评分（OR=1.058）、消极应对（OR=1.085）、社会支持（OR=0.867）、焦虑情绪（OR=1.077）及血管再通不良（OR=3.093）均是ACI患者溶栓后1个月自我效能感低下的相关因素（P<0.05）。结论在溶栓后1个月，仍有部分ACI患者存在自我效能感低下。NIHSS评分较高、倾向于消极应对方式、焦虑情绪严重及血管再通不良均是患者自我效能感低下的危险因素；社会支持水平高是其保护因素。建议在急性期康复管理中，早期结合心理疏导、社会支持强化及认知行为干预，以提升其康复信心与自我管理能力，从而优化长期预后。

关键词: 急性脑梗死, 静脉溶栓, 自我效能感, 影响因素, 康复护理

Abstract:

Objective To explore the level of self-efficacy in patients with acute cerebral infarction（ACI） after intravenous thrombolytic therapy and the influencing factors，in order to provide a basis for the targeted formulation of psychological intervention and rehabilitation support strategies，to enhance the patients’ confidence in recovery and promote the recovery of neurological function. Methods By using the continuous sampling method，300 patients with acute cerebral infarction（ACI） who received intravenous thrombolysis treatment in a tertiary grade A hospital in Nanjing from January 2023 to January 2025 were selected as the research subjects. The General Self-Efficacy Scale（GSES） questionnaire was used to assess the patients one month after thrombolysis. The patients were divided into the group with good self-efficacy and the group with low self-efficacy based on the scores. Univariable and multivariable logistic regression analysis were used to investigate the factors related to the low self-efficacy of ACI patients after intravenous thrombolysis. Results The GSES score of 300 ACI patients was（25.47±5.61） one month after thrombolysis，237（79.00%） patients had good self-efficacy，while 63（21.00%） had poor self-efficacy. Compared with the group with good efficacy，patients in the group with low efficacy had higher NIHSS scores，negative coping scores，anxiety scores，a higher proportion of poor vascular recanalization，and lower social support scores（P<0.05）. Multivariable logistic regression model analysis showed that NIHSS score（OR=1.058），coping style （OR=1.085），social support（OR=0.867），anxiety（OR=1.077），and poor vascular recanalization（OR=3.093） were all associated factors for low self-efficacy in ACI patients one month after thrombolysis（P<0.05）. and anxiety（OR=1.077） were all related factors for low self-efficacy in ACI patients after thrombolytic therapy（P<0.05）. Conclusion At the assessment point one month after thrombolysis，a significant number of patients with ACI still exhibited low self-efficacy. Higher NIHSS score，tendency towards negative coping style，severe anxiety，and poor vascular recanalization were all risk factors for low self-efficacy. Higher level of social support was a protective factor. It is recommended that in the acute rehabilitation management，psychological counseling，social support reinforcement and cognitive behavioral intervention should be combined in the early stage to enhance their rehabilitation confidence and self-management ability，thereby optimizing the long-term prognosis.

Key words: Acute Cerebral Infarction, Intravenous Thrombolysis, Self-Efficacy, Influencing Factors, Rehabilitation Nursing

蔡询, 刘才荣, 黄琴. 急性脑梗死患者溶栓治疗后自我效能感调查及影响因素分析[J]. 中华急危重症护理杂志, 2026, 7(10): 1179-1186.

CAI Xun, LIU Cairong, HUANG Qin. Investigation on self-efficacy and analysis of influencing factors in patients with acute cerebral infarction after thrombolytic therapy[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(10): 1179-1186.

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