The impact of anger in adherence to treatment and beliefs about disease 1 year after stroke
The impact of anger in adherence to treatment and beliefs about disease 1 year after stroke
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DOI：
10.1007/s00415-017-8577-x
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发表时间：
2017-09-01
影响因子：
6
通讯作者：
Ferro, Jose M.
中科院分区：
文献类型：
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作者：
Catarina Santos, A.;Ferro, Jose M.
愤怒是中风后常见的神经精神症状，它可能会干扰治疗和恢复，特别是通过影响对治疗和健康护理教育的依从性行为。本研究的目的是随访一组中风患者中风后12个月，以描述愤怒的存在，比较急性和急性后愤怒的水平和特征，并分析其对治疗依从性和中风信念的影响。我们随访了91例卒中患者（平均随访13.3个月），采用标准化方案，使用状态-特质愤怒表达量表-2（STAXI-2）评估愤怒及其成分的频率和概况，并使用一份问卷测量治疗依从性和健康教育（治疗意义）（Adh-T）。我们使用急性期收集的社会人口统计学、临床、卒中类型和部位信息作为解释变量。15例（17%）患者检测到愤怒状态，7例（8%）患者存在愤怒特质。最佳回归模型显示，性格愤怒、卒中部位（后部梗死）和卒中后遗症的影响是愤怒的独立预测因素（R（2）= 43%）。愤怒表达水平较高的患者依从率较低，与依从性维度无关。在中风后的慢性期，愤怒与后部病变、中风后果的影响以及愤怒作为一种人格特质有关。愤怒的检测和监测最终可以防止愤怒的负面影响，特别是在坚持康复和二级预防。
Anger is a frequent neuropsychiatric symptom after stroke, which can disrupt treatment and recovery, in particular by affecting adherence behaviour to treatment and health care education. This study aimed to follow-up a cohort of stroke patients 12 months after their stroke to describe the presence of anger, compare levels and profile of acute and post-acute anger and analyse its impact on the adherence to treatment and beliefs about stroke. We followed (13.3 months mean follow-up) 91 stroke patients with a standardized protocol, using State-Trait Anger Expression Inventory-2 (STAXI-2) to assess the frequency and profile of anger and its components and one questionnaire to measure adherence to treatment and health education (meaning on the treatment) (Adh-T). We used as explanatory variables socio-demographic, clinical, stroke type and location information collected during the acute phase. Anger-state was detected in 15 (17%) patients, while anger-trait was present in 7 (8%) patients. The best regression model revealed that trait-anger, stroke location (posterior infarcts), and impact of stroke sequels were independent predictive factors for anger (R (2) = 43%). Patients with higher levels of anger expression had lower adherence rates, independently of the adherence dimension. In the chronic phase after stroke anger was related with posterior lesions, the impact of stroke consequences and anger as a personality trait. The detection and monitoring of anger could eventually prevent the negative impact of anger in care, especially in adherence to rehabilitation and secondary prevention.