疾病感知和用药信念在急性缺血性脑卒中患者的神经功能缺损与认知功能间的中介效应研究
Mediating Effects of Disease Perception and Medication Belief on Neurological Impairment and Cognitive Function in Patients with Acute Ischemic Stroke
摘要: 目的：探讨疾病感知和用药信念在急性缺血性脑卒中(AIS)患者的神经功能缺损对患者认知功能机制中的多重中介作用。方法：采用便利抽样法，选取2023年11月~2024年11月盐城市某三级甲等医院神经内科收治的209例AIS患者为研究对象，采用一般资料调查表、药物信念问卷(BMQ)、简易疾病感知问卷(BIPQ)、美国国立卫生研究院卒中量表(NIHSS)及蒙特利尔认知评估量表(MoCA)进行调查。采用Pearson相关性分析疾病感知及治疗信心与神经功能缺损、认知功能的相关性，并采用多元层次回归分析疾病感知及用药信念在神经功能缺损与认知功能间的中介效应，构建并检验中介模型。结果：AIS患者的BIPQ得分为(47.21 ± 12.30)分、BMQ得分为1 (−3, 3)分、NIHSS得分为(3.25 ± 0.86)分，MoCA得分为(19.75 ± 5.64)分。疾病感知及用药信念与认知功能均呈正相关(P < 0.001)，神经功能缺损与认知功能呈负相关(P < 0.001)。多元层次回归法分析显示，疾病感知及用药信念在AIS神经功能缺损与认知功能间存在中介效应(P < 0.05)。疾病感知和用药信念在神经功能缺损与认知功能间起到中介效应值分别为−0.120、−0.119，分别占总效应的22.2%、22.0%，其中间接效应占总效应的44.2%。结论：疾病感知和用药信念在急性缺血性脑卒中患者神经功能缺损与认知功能间的中介效应成立，建议医护人员应重视同步关注患者疾病认知重构与治疗信念强化，通过心理疏导与行为支持等行为，促进其认知与身心整体康复。
Abstract: Objective: To investigate the multiple mediating roles of disease perception and medication belief in the influence of neurological deficit on cognitive function in patients with acute ischemic stroke (AIS). Methods: A total of 209 patients with AIS were selected by convenience sampling method from November 2023 to November 2024 in a tertiary first-class hospital of Yancheng City. The general data questionnaire, drug belief questionnaire (BMQ), brief disease perception questionnaire (BIPQ), National Institute of Health Stroke Scale (NIHSS) and Montreal Cognitive Assessment (MoCA) were used to investigate. Pearson correlation analysis was used to analyze the correlation between disease perception and treatment confidence and neurological impairment and cognitive function. Multiple hierarchical regression analysis was used to analyze the mediating effect of disease perception and medication belief between neurological impairment and cognitive function. Psychological status of AIS patients was assessed by the scores of BIPQ, BMQ, NIHSS and MoCA. Results: The scores of BIPQ, BMQ, NIHSS and MoCA were (47.21 ± 12.30), (−3, 3), (3.25 ± 0.86) and (19.75 ± 5.64) respectively. There was a positive correlation between disease perception and medication belief and cognitive function (P < 0.001), and a negative correlation between neurological deficit and cognitive function (P < 0.001). Multiple regression analysis showed that disease perception and medication belief had a mediating effect between neurological impairment and cognitive function in AIS (P < 0.05). The mediate effect values of disease perception and medication belief between neurological deficit and cognitive function were −0.120, −0.119, which account for 22.2% and 22.0% of that total effect, respectively, and the total indirect effect accounted for 44.2% of the total effect. Conclusion: The mediating effect of disease perception and medication belief between neurological deficit and cognitive function in patients with acute ischemic stroke is established. It is suggested that medical staff should pay attention to the reconstruction of disease cognition and the strengthening of treatment belief, and promote their cognitive and physical and mental rehabilitation through psychological counseling and behavior support.
文章引用：韩立健, 刘建平, 罗容, 张娴娴, 王淑芳. 疾病感知和用药信念在急性缺血性脑卒中患者的神经功能缺损与认知功能间的中介效应研究[J]. 护理学, 2026, 15(5): 225-235. https://doi.org/10.12677/ns.2026.155163

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