作者：徐阳1 ，张瑜1 ，刘银侠1 ，杨艳2 ，房会娥3 ，刘一辉2 ，俞萍1，4

单位：

1.225009 江苏省扬州市，扬州大学护理学院·公共卫生学院　 2.225000 江苏省扬州市，扬州大学附属医院 神经内科　3.225000 江苏省扬州市，扬州大学附属医院神经外科　 4.225000 江苏省扬州市，扬州大学附属医院护理部

Units：

1.School of Nursing·School of Public Health, Yangzhou University, Yangzhou 225009, China 2.Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou 225000, China 3.Department of Neurosurgery, Affiliated Hospital of Yangzhou University, Yangzhou 225000, China 4.Department of Nursing, Affiliated Hospital of Yangzhou University, Yangzhou 225000, China

关键词：

卒中；中年人；青年人；配偶；心理体验；应对方式；定性研究

Keywords：

Stroke; Middle aged; Young adult; Spouses; Psychological experience; Coping style; Qualitative research

CLC：

R 743

DOI：

10.12114/j.issn.1008-5971.2024.00.084

Funds：

国家自然科学基金资助项目（82201394）

摘要：

　目的　基于ABC-X模型探讨首发中青年脑卒中患者配偶的心理体验及应对方式。方法　采用目的抽样 法选取2023年6—10月在扬州大学附属医院神经内科住院治疗的首发中青年脑卒中患者的配偶为研究对象。样本量以 受访者的资料重复出现且资料分析不再有新的主题呈现为标准，本研究最终纳入16例受访者。以ABC-X模型为指导， 根据研究目的、文献回顾、专家咨询结果、预访谈制定正式访谈提纲，对受访者进行半结构化访谈。采用Colaizzi 7步 分析法和Nvivo 11.0软件进行资料整理。结果　共提炼出4个主题，分别为配偶的压力源事件（包括经济压力、工作压 力、照护负担）、配偶压力应对资源（包括个人资源、家庭资源、社会支持资源）、配偶的心理体验（包括疾病初诊 时的恐惧、连带病耻感、担心患者预后、渴望社会支持）、配偶对压力事件的应对方式〔分为积极应对（寻求社会支 持，设定目标、规划生活）、消极应对（无奈接受、削弱患者自理能力）〕。结论　首发中青年脑卒中患者配偶存在 多重压力，而其压力应对资源相对缺乏，且其疾病初诊时的恐惧、连带病耻感、担心患者预后、渴望社会支持等心理 体验会导致负性情绪的产生，从而导致无奈接受、削弱患者自理能力等消极应对方式。因而医务人员应为首发中青年 脑卒中患者配偶构建积极的压力应对方案，鼓励其主动寻求社会支持，并设定目标、规划未来，从而促进患者康复。

Abstract：

Objective To explore the psychological experience and coping style of spouses of first-episode middle aged and young stroke patients based on the ABC-X model. Methods Spouses of first-episode middle-aged and young stroke patients who were hospitalized in the Department of Neurology, Affiliated Hospital of Yangzhou University from June to October 2023 were selected as the study objects by objective sampling method. The sample size was based on the fact that the data of the respondents were repeated and no new topics were presented in the data analysis, and 16 respondents were finally included in this study. Guided by the ABC-X model, a formal interview outline was formulated according to the research purpose, literature review, expert consultation results and pre-interview, and semi-structured interviews were conducted. Colaizzi 7-step analysis method and Nvivo 11.0 software were used to organize the data. Results Four themes were extracted, namely spousal stressor events (including economic pressure, work pressure, care burden) , spousal stress coping resources (including personal resources, family resources, and social support resources) , spousal psychological experiences (including fear at the first diagnosis of the disease, associated stigma, concerns about patients' prognosis and a desire for social support) , and spousal coping styles towards stress events [divided into positive coping (seeking social support, setting goals and planning life) and negative coping (reluctantly accepting, weakening patients' self-care ability] . Conclusion The spouses of first-episode middle-aged and young stroke patients have multiple pressures, and their stress coping resources are relatively scarce. Moreover, the psychological experiences of fear at the first diagnosis of the disease, associated stigma, concerns about patients' prognosis and a desire for social support can lead to negative emotions, leading to passive coping methods such as reluctantly accepting, weakening patients' self-care ability. Therefore, medical personnel should construct a positive stress coping plan for spouses of first-episode middle-aged and young stroke patients, encourage them to actively seek social support, set goals and plan for the future, so as to promote the recovery of patients.

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