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Objective:The purpose of this study was to investigate the association of insomnia with social factors, vascular risk factors and neurological status in patients with cerebral infarction.Methods:217 patients with first onset cerebral infarction in Army Medical Center of PLA were enrolled in this study. According to the athens insomnia scale (AIS) score, the patients were divided into cerebral infarction insomnia group (total score >6 points) and cerebral infarction non insomnia group (total score ≤6 points). The correlation between the occurrence of insomnia in patients with cerebral infarction and humanistic factors, vascular risk factors and cerebral infarction characteristics was analyzed.Results:The incidence of insomnia in patients with cerebral infarction was 61.8%(134/217). There were significant differences in age, education level, monthly income, occupational status, depression, hypertension, diabetes mellitus, vascular control area, infarction site, National Institutes of Health Stroke Scale (NIHSS) score, activities of daily living [Barthel Index (BI) score] and aphasia between insomnia group and non insomnia group ( P<0.05); Multivariate logistic regression analysis showed that age, depression, NIHSS score, BI score and aphasia were independently associated with insomnia after cerebral infarction ( P<0.05). Conclusions:Age, depression, NIHSS score, BI score and aphasia were independent risk factors for insomnia in patients with cerebral infarction.
RESUMO
Objective To explore the related factors and nursing interventional methods of depression in patients with motor aphasia after stroke. Methods The Stroke Aphasic Depression Questionnaire-Hospital version (SADQ-H) was used to diagnose depression of 271 patients with motor aphasia after stroke. The association of post-stroke depression with social factors, vascular risk factors and stroke features were analyzed. The relationship between depression severity and aphasia severity were analyzed. A total of 166 patients with depression were divided into the control group and the observation group to carry out different nursing interventional methods. Results The incidence of post-stroke depression in patients with motor aphasia was 61.3%(166/271). The occurrence of post-stroke depression was correlated with female (χ2=5.580, P=0.02) , age less than 60 years old (χ2=4.390, P=0.04) , living alone (χ2=5.400, P=0.02) , recent negative events (χ2=4.420, P=0.04). The multi-factor Logistic regression analysis showed that the occurrence of post-stroke depression was independently associated with female (OR=2.58, 95%CI 2.12-3.86, P<0.01), age less than 60 years old(OR=2.62, 95%CI 2.16-3.94, P<0.01), living alone(OR=2.59, 95%CI 2.13-3.92, P<0.01). After 4 weeks of nursing intervention, there were significant differences in SADQ-H scores (t=2.94, P=0.002) and distribution of Boston Diagnostic Aphasia Examination (BDAE) (χ2=14.045,P=0.000) between the control group and the observation group. Conclusions Female, ages less than 60 years old, living alone are independent risk factors of post-stroke depression in motor aphasia patients. The degree of depression is associated with aphasia severity. The early nursing intervention can improve the depression status and promote recovery of the language function of patients with motor aphasia after stroke.