首发老年缺血性脑卒中患者早期康复决策后悔的潜在类别及影响因素分析

Analysis of Potential Categories of Early Rehabilitation Decision Regret in First-Ever Elderly Ischemic Stroke Patients and Their Influencing Factors

摘要: 目的：探讨首发老年缺血性脑卒中患者早期康复决策后悔的潜在类别及影响因素，为识别高决策后悔风险患者提供参考。方法：采取便利抽样法，选取2023年11月至2024年11月盐城市第三人民医院神经内科住院的首发老年缺血性脑卒中患者254例，于入院后第14天采用一般资料调查表、决策后悔量表、决策自我效能量表、经济毒性量表及健康状况调查简表进行调查。采用潜在类别分析识别患者早期康复决策后悔的潜在类别，使用无序多分类Logistic回归分析其影响因素。结果：首发老年缺血性脑卒中患者早期康复决策后悔可分为3个潜在类别，分别为高认同–低后悔型(45.8%)、中立–中等后悔型(21.2%)和低认同–高后悔型(33.1%)。受教育程度、医疗支付方式、决策自我效能、经济毒性及健康状况与首发老年缺血性脑卒中患者早期康复决策后悔的潜在类别显著相关(均P < 0.05)。结论：首发老年缺血性脑卒中患者早期康复决策后悔存在明显的群体异质性。临床应重点关注高决策后悔风险患者，针对不同类别的患者开展个体化干预，以降低决策后悔、提升康复决策质量与长期康复体验。

Abstract: Objective: To identify the potential categories and influencing factors of early rehabilitation decision regret in elderly patients with first-episode ischemic stroke, so as to provide evidence for identifying patients with high risk of decision regret. Methods: A total of 254 inpatients from the Department of Neurology of Yancheng Third People’s Hospital from November 2023 to November 2024 were selected by convenience sampling method. The general data questionnaire, decision regret scale, decision self-efficacy scale, economic toxicity scale and health status questionnaire were investigated on the 14th day after admission. Latent class analysis (LCA) was used to identify the potential categories of decision regret, and multiple logistic regression analysis was used to explore the influencing factors. Results: Three latent classes of decisional regret were identified: high identification-low regret (45.8%), neutral-moderate regret (21.2%), and low identification-high regret (33.1%). Education level, medical payment type, decision self-efficacy, financial toxicity, and health status were significantly associated with class membership (all P < 0.05). Conclusion: There is significant group heterogeneity in early rehabilitation decision regret in elderly patients with first episode ischemic stroke. Clinicians should focus on identifying patients with high risk of decision regret and carry out individualized interventions for different categories of patients to reduce decision regret and improve the quality of rehabilitation decisions and long-term rehabilitation experience.