中青年脑卒中患者夫妻二元心理健康轨迹及其互助干预模式研究

鉴于当前脑卒中发病率及致残率高居不下且趋于年轻化，中青年脑卒中患者夫妻心理问题突出，本项目拟基于前期在积极心理学视角下对脑卒中患者及照顾者获益感初步探索的研究基础，参考二元理念，以中青年脑卒中患者夫妻二元心理健康为切入点，开展横断面研究，从正性和负性角度全面收集夫妻双方的生理（炎性因子及皮质醇等）心理反应指标，采用主客体互倚模型、潜在类别分析等明确双方二元心理健康的发生机制，并纵向随访其出院后1、3、6、9、12个月的二元心理健康状况，通过发展混合模型等明确其发展轨迹及类型，获取最佳干预介入点及分类干预对象；结合Delph专家咨询等构建以互助为主线、专业指导为辅线的二元互助干预模式及研发其APP平台，以随机对照实证研究优化干预模式，以促进中青年脑卒中患者夫妻积极心理的相互影响且共同变化，最终促进双方的二元心理健康，以期为我国慢性病患者及其家庭照顾者等重点人群的心理健康服务提供科学依据。

Due to the high incidence rate and morbidity of stroke, patients with stroke tend to be younger, and the serious psychological problems of young and middle-aged patients with stroke and their spouse caregivers, this study takes dyadic mental health in young and middle-aged patients with stroke and their spouse caregivers as the breakthrough point,aiming to explore the mechanism and trajectories of their dyadic mental health and construct mutual intervention modes based on the dyadic idea and the research basis about benefits findings of stroke survivors and their family caregivers on the perspective of positive psychology. Firstly, a cross-sectional study will be performed, both positive and negative physiological (such as inflammatory factor and cortisol) and psychological reaction indexes of the stroke couples will be collected, the actor-partner interdependence model, latent class analysis etc.will be used to explore the mechanism of their dyadic mental health. Secondly, the dyadic mental health of 1, 3, 6, 12 months after discharge of stroke couples will be followed up, and the growth mixture model were used to determine the trajectory and different types to obtain the best intervention time point and classified intervention objects. Thirdly, the Delph expert consultation will be conducted based on our preliminary study to construct the intervention mode of dyadic mental health which consists of mutual help as main part and professional guides as minor part. moreover, the APP intervention platform will be developed according to the mode. Finally, a randomized controlled trial will be performed to test the effect and adjust the APP intervention mode, to promote mutual influence and mutual positive psychological changes among young and middle-aged patients with strokes and their spouse caregivers, and to improve the dyadic mental health, to provide scientific evidence for the mental health services of patients with chronic diseases and their family caregivers in China.