目的 探讨决策自我效能在脑卒中患者康复需求与决策冲突间的中介效应,为改善脑卒中患者决策冲突现状提供参考。方法 2023年12月至2024年3月,便利抽样法选取3所郑州市三级医院的305例脑卒中患者为调查对象,采用一般资料调查表、决策冲突量表、决策自我效能量表及康复需求量表对其调查,采用AMOS 23.0构建中介效应模型。结果 脑卒中患者决策冲突、决策自我效能、康复需求得分分别为(38.52±12.80)、(53.28±14.80)和(103.91±18.33)分。康复需求与决策冲突呈负相关(r=-0.279,P<0.001),与决策自我效能呈正相关(r=0.219,P<0.001);决策自我效能与决策冲突呈负相关(r=-0.480,P<0.001)。脑卒中患者决策自我效能在康复需求与决策冲突间的中介效应成立(β=-0.096,95%CI -0.169~-0.037),占总效应的35.7%。结论 决策自我效能在脑卒中患者康复需求与决策冲突间发挥部分中介作用,可关注脑卒中患者决策自我效能,从而改善其决策冲突现状。

Objective To explore the mediating effect of decision self-efficacy between rehabilitation needs and decisional conflict in patients with stroke,so as to provide a reference for improving the current status of decisional conflict in stroke patients.Methods From December 2023 to March 2024,305 stroke patients from three Grade A tertiary hospitals in Zhengzhou were selected by convenience sampling.They were surveyed using the General Information Questionnaire,the Decisional Conflict Scale,the Decision Self-efficacy Scale,and the Rehabilitation Needs Scale.AMOS 23.0 was used to construct the mediation effect model.Results The scores of decisional conflict,decision self-efficacy,and rehabilitation needs in stroke patients were(38.52±12.80),(53.28±14.80),and (103.91±18.33),respectively.Rehabilitation needs were negatively correlated with decisional conflict(r=-0.279,P<0.001) and positively correlated with decision self-efficacy(r=0.219,P<0.001).Decision self-efficacy was negatively correlated with decisional conflict(r=-0.480,P<0.001).The mediating effect of decision self-efficacy between rehabilitation needs and decisional conflict in stroke patients was established(β=-0.096,95%CI -0.169--0.037),accounting for 35.7% of the total effect.Conclusions Decision self-efficacy plays a partial mediating role between rehabilitation needs and decisional conflict in stroke patients,suggesting that clinical practice can focus on the target of decision self-efficacy to improve patients' decisional conflict.

R473.74;R47-05

国家自然科学基金项目(72004205)；老年长期照护教育部重点实验室开放基金(LNYBPY-2023-01)；河南省重点研发与推广专项(242102310295,252102310157)；教育部产学合作协同育人项目"智慧护理人因与工效学联合实验室"(230905329045253)；河南省创新创业本科培训计划(S202510459193)