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