关键词: 脑卒中, 心理痛苦, 轨迹, 预测因素, 增长混合模型

Abstract: Objective To explore the developmental trajectory and predictors of psychological distress in elderly stroke patients. Methods A prospective longitudinal study design was used to select 230 elderly stroke patients from the department of neurology of a tertiary A-level hospital in Baoding city from June to July 2023, and the level of psychological distress was assessed using a psychological distress thermometer in stroke patients on the day of admission at 2 weeks, 6 weeks, 8 weeks, 12 weeks, and 24 weeks post-stroke respectively, applying a growth mixture model to identify the developmental trajectories of psychological distress, and applying univariate analyses and Logistic regressions to analyse the influences on the categories of trajectories. Results A total of three trajectories of psychological distress were identified, namely the “persistent psychological distress group”(23%), the “unstable psychological distress group”(21%), and the “no psychological distress group”(56%). Logistic regression analysis showed that age, functional impairment, coping style, and psychological resilience were the main predictors of psychological distress trajectories in elderly stroke patients. Conclusion There is group heterogeneity in the trajectory of psychological distress in elderly stroke patients, and patient-specific interventions should be given.

Key words: stroke, psychological distress, trajectory, predictors, growth mixture model