Correlation of Mental Health Literacy between Stroke Patients and Their Caregivers

doi:10.12114/j.issn.1007-9572.2021.00.208

Abstract

Abstract: Background　As a whole，both stroke patients and their caregivers face mental health problems during treatment. Improving mental health literacy is conducive to mental health，but there is a lack of investigations on the status and relationship regarding mental health literacy in stroke patients and their caregivers. Objective　To explore the correlation of mental health literacy between stroke patients and their caregivers，providing a basis for formulating corresponding interventions. Methods　This investigation was conducted between July and October 2020 with 580 stroke patient-caregiver pairs selected using convenience sampling from three hospitals of Henan Province using the Chinese version of the Multicomponent Mental Health Literacy Measure（MMHLM-C）. The correlation of mental health literacy between patients and their caregivers was analyzed. Results　In all，558 patient-caregiver pairs（96.2%） who returned responsive questionnaires were included for final analysis. The total score of the MMHLM-C and subscale scores of knowledge-oriented，beliefs-oriented，and resource-oriented mental health literacy were 8（8），4（4），4（4），0（1），respectively for stroke patients，and were 8（8），4（4），3（3），0（2），respectively，for caregivers. The mental health literacy level of stroke patients was positively correlated with that of caregivers（rs=0.715，P<0.001）. Conclusion　The mental health literacy was low in both stroke patients and their caregivers，and was positively correlated. So nurses should pay attention to give health education to both stroke patients and their caregivers simultaneously to achieve mutual promotion to improve their mental health literacy.

Key words: Stroke, Patients, Caregivers, Mental health literacy, Correlation

摘要： 背景　在应对疾病的过程中，脑卒中患者与其照顾者作为一个二元整体均面临着心理健康问题。心理健康素养水平的提高有助于心理健康，而目前缺乏脑卒中患者与其照顾者心理健康素养关系的现状及相关性调查。目的　探讨脑卒中患者与其照顾者心理健康素养的相关性，为制定相应的干预措施提供依据。方法　2020年7—10月，采取便利抽样的方法，在河南省3所医院抽取脑卒中患者及其照顾者共580对，采用多元心理健康素养量表对患者及其照顾者心理健康素养情况进行调查，分析两者的相关性。结果　发放问卷580份，回收有效问卷558份，有效回收率为96.2%。脑卒中患者心理健康素养总得分为8（8）分，脑卒中患者心理健康知识、信念和资源维度得分分别为4（4）、4（4）、0（1）分；脑卒中患者照顾者心理健康素养总得分为8（8）分，脑卒中患者照顾者心理健康知识、信念和资源维度得分分别为4（4）、3（3）、0（2）分。脑卒中患者心理健康素养水平与其照顾者心理健康素养水平呈正相关（rs=0.715，P<0.001）。结论　脑卒中患者及其照顾者心理健康素养均处于低水平且二者呈正相关，护士在进行健康教育时，应注重对脑卒中患者及其照顾者的同步教育，以期达到双方相互促进，共同提高心理健康素养的目的。

关键词: 卒中, 患者, 照顾者, 心理健康素养, 相关性

ZHANG Zhenxiang,LI Hui,PING Zhiguang, et al. Correlation of Mental Health Literacy between Stroke Patients and Their Caregivers　[J]. Chinese General Practice, 2021, 24(22): 2855-2859. DOI: 10.12114/j.issn.1007-9572.2021.00.208.
张振香,李会,平智广等. 脑卒中患者与其照顾者心理健康素养的相关性研究[J]. 中国全科医学, 2021, 24(22): 2855-2859. DOI: 10.12114/j.issn.1007-9572.2021.00.208.

References

［1］FEIGIN V L，NORRVING B，MENSAH G A. Global burden of stroke［J］. Circ Res，2017，120（3）：439-448. DOI：10.1161/CIRCRESAHA.116.308413.
［2］王陇德，刘建民，杨弋，等. 我国脑卒中防治仍面临巨大挑战——《中国脑卒中防治报告2018》概要［J］. 中国循环杂志，2019，34（2）：105-119. DOI：10.3969/j.issn.1000-3614.2019.02.001.
WANG L D，LIU J M，YANG Y，et al. Stroke prevention and treatment in China still faces great challenges：summary of China Stroke Prevention and Treatment Report 2018 Profile［J］. Chinese Journal of Circulation，2019，34（2）：105-119. DOI：10.3969/j.issn.1000-3614.2019.02.001.
［3］TAY J L，TAY Y F，KLAININ-YOBAS P. Mental health literacy levels［J］. Arch Psychiatr Nurs，2018，32（5）：757-763. DOI：10.1016/j.apnu.2018.04.007.
［4］关菲，蒋虹，齐丽娜，等. 运动引导想象训练对脑卒中后病人焦虑、抑郁和疼痛的影响［J］. 护理研究，2020，34（4）：590-594. DOI：10.12102/j.issn.1009-6493.2020.04.005.
GUAN F，JANG H，QI L N，et al. Effects of motion-guided imagination training on anxiety，depression and pain in post-stroke patients［J］. Nursing Research，2020，34（4）：590-594. DOI：10.12102/j.issn.1009-6493.2020.04.005.
［5］JARACZ K，GRABOWSKA-FUDALA B，GORNA K，et al. Burden in caregivers of long-term stroke survivors：prevalence and determinants at 6 months and 5 years after stroke［J］. Patient Educ Couns，2015，98（8）：1011-1016. DOI：10.1016/j.pec.2015.04.008.
［6］郭恒，盛小添，笪姝，等. 心理健康素养的概念、测量及影响因素［J］. 中国健康教育，2017，33（10）：918-922. DOI：10.16168/j.cnki.issn.1002-9982.2017.10.013.
GUO H，SHENG X T，DA S，et al. The concept，measurement and influencing factors of mental health literacy［J］. Health Education in China，2017，33（10）：918-922. DOI：10.16168/j.cnki.issn.1002-9982.2017.10.013.
［7］G?RI? S，KL? Z，ELMAL F，et al. Care burden and social support levels of caregivers of patients with chronic obstructive pulmonary disease［J］. Holist Nurs Pract，2016，30（4）：227-235. DOI：10.1097/HNP.0000000000000153.
［8］JORM A F，KORTEN A E，JACOMB P A，et al. "Mesntal health literacy"：a survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment［J］. Med J Aust，1997，166（4）：182-186. DOI：10.5694/j.1326-5377.1997.tb140071.x.
［9］CHEUNG T Y，ONG Y Y，NG T，et al. Assessment of mental health literacy in patients with breast cancer［J］. J Oncol Pharm Pract，2016，22（3）：437-447. DOI：10.1177/1078155215587541.
［10］LEE H Y，HWANG J，BALL J G，et al. Mental health literacy affects mental health attitude：is there a gender difference?［J］. Am J Health Behav，2020，44（3）：282-291. DOI：10.5993/AJHB.44.3.1.
［11］中华医学会神经病学分会，中华医学会神经病学分会脑血管病学组. 中国各类主要脑血管病诊断要点2019［J］. 中华神经科杂志，2019，52（9）：710-715. DOI：10.3760/cma.j.issn.1006?7876.2019.09.003.
［12］JUNG H，VON STERNBERG K，DAVIS K. Expanding a measure of mental health literacy：development and validation of a multicomponent mental health literacy measure［J］. Psychiatry Res，2016，243：278-286. DOI：10.1016/j.psychres.2016.06.034.
［13］明志君，陈祉妍，王雅芯，等. 中文版多元心理健康素养量表在男性军人中信效度评价［J］. 中国公共卫生，2021，37（1）：86-91. DOI：10.11847/zgggws1123418.
MING Z J，CHEN Z Y，WANG Y X，et al. Evaluation of Chinese Multivariate Mental Health Literacy Scale on the CID validity of male soldiers［J］. Public Health in China，2021，37（1）：86-91. DOI：10.11847/zgggws1123418.
［14］FRIIS K，PEDERSEN M H，AABY A，et al. Impact of low health literacy on healthcare utilization in individuals with cardiovascular disease，chronic obstructive pulmonary disease，diabetes and mental disorders. A Danish population-based 4-year follow-up study［J］. Eur J Public Health，2020，30（5）：866-872. DOI：10.1093/eurpub/ckaa064.
［15］TONSING K N. A review of mental health literacy in Singapore［J］. Soc Work Health Care，2018，57（1）：27-47. DOI：10.1080/00981389.2017.1383335.
［16］BONABI H，MARIO M，AJDACIC-GROSS V，et al. Mental health literacy，attitudes to help seeking，and perceived need as predictors of mental health service use：a longitudinal study［J］. J Nerv Ment Dis，2016，204（4）：321-324. DOI：10.1097/NMD.0000000000000488.
［17］邓翠玉，赵岳，卢琦. 脑卒中患者病耻感的研究进展［J］. 中华护理杂志，2016，51（6）：733-736. DOI：10.3761/j.issn.0254-1769.2016.06.021.
DENG C Y，ZHAO Y，LU Q. Research progress of stigma in stroke patients［J］. Chinese Journal of Nursing，2016，51（6）：733-736. DOI：10.3761/j.issn.0254-1769.2016.06.021.
［18］RAFFIN E，HUMMEL C F. Restoring motor functions after stroke：multiple approaches and opportunities［J］. Neuroscientist，2018，24（4）：400-416. DOI：10.1177/1073858417737486.
［19］BUCKI B，SPITZ E，BAUMANN M. Eomtional and social respercussions of strokeon patient-family caregiver dyads：analysis of diverging attitudes and profiles of the differing dyads［J］. PLoS One，2019，14（4）：e0215425. DOI：10.1371/journal.pone.0215425.
［20］HURLEY D，SWANN C，ALLEN M S，et al. A systematic review of parent and caregiver mental health literacy［J］. Community Ment Health J，2020，56（10）：2-21. DOI：10.1007/s10597-019-00454-0.
［21］QIU X，SIT J W H，KOO F K. The influence of Chinese culture on family caregivers of stroke survivors：a qualitative study［J］. J Clin Nurs，2018，27（1/2）：e309-319. DOI：10.1111/jocn.13947.
［22］何叶，王元姣. 脑卒中家庭主要照顾者社会支持性服务的研究进展［J］. 中华现代护理杂志，2020，26（30）：4287-4292. DOI：10.3760/cma.j.cn115682-20200410-02637.
［23］李银萍，刘昌龄，涂双燕，等. 脑卒中病人照顾者需求状况研究进展［J］. 护理研究，2019，33（4）：73-76. DOI：10.12102/j.issn.1009-6493.2019.04.016.
［24］PICCO L，ABDIN E，CHONG S A，et al. Attitudes toward seeking professional psychological help：factor structure and socio-demographic predictors［J］. Front Psychol，2016，7：547. DOI：10.3389/fpsyg.2016.00547.
［25］KAYROUZ R，DEAR B F，JOHNSTON L，et al. Intergenerational and cross-cultural difffferences in emotional wellbeing，mental health service utilisation，treatment-seeking preferences and acceptability of psychological treatments for Arab Australians［J］. Int J Soc Psychiatry，2015，61（5）：484-491. DOI：10.1177/0020764014553004.
［26］GOLAY P，ALAMEDA L，BAUMANN P，et al. Duration of untreated psychosis：impact of the definition of treatment onset on its predictive value over three years of treatment［J］. J Psychiatr Res，2016，77：15-21. DOI：10.1016/j.jpsychires.2016.02.017.
［27］LYONS K S，LEE C S. The theory of dyadic illness management［J］. J Fam Nurs，2018，24（1）：8-28. DOI：10.1177/1074840717745669.
［28］TERRILL A L，REBLIN M，MACKENZIE J J，et al. Development of a novel positive psychology-based intervention for couples post-stroke［J］. Rehabil Psychol，2018，63（1）：43-54. DOI：10.1037/rep0000181.

[1]	QIN Fengyin, ZHANG Qishan, LAI Jinjia, HUANG Yimin, HAN Guoyin, SUN Xinglan, WANG Fen, TAN Yibing. Current Status and Influencing Factors of the Intention to Screen for High-risk Stroke among Community Residents in Guangdong [J]. Chinese General Practice, 2023, 26(34): 4283-4289.
[2]	LI Qianqian, CHEN Xunrui, ZHANG Wenying, YUAN Haihua, ZHANG Yanjie, JIANG Bin, LIU Feng. Demand and Influencing Factors for Community Health Services during Chemotherapy of Patients with Advanced Cancer [J]. Chinese General Practice, 2023, 26(33): 4173-4180.
[3]	SU Kaiqi, LYU Zhuan, WU Mingli, LUO Meng, GAO Jing, NIE Chenchen, LIU Hao, FENG Xiaodong. Effect of Electroacupuncture on BDNF/TrkB/PI3K/Akt Pathway and Hippocampal Neuronal Protection in Rats with Learning and Memory Impairment after Ischemia Reperfusion [J]. Chinese General Practice, 2023, 26(33): 4187-4193.
[4]	YIN Miaomiao, CUI Liling, LI Yaqing, WANG Liqun, ZHANG Yue, WU Jialing. Effect of Dual Task on Walking Ability in Posterior Circulation Ischemic Stroke Patients with Vestibular Symptoms [J]. Chinese General Practice, 2023, 26(33): 4207-4212.
[5]	YANG Yuxuan, ZHANG Han, DU Juan, WANG Lingling, XIE Yulei, YIN Kaiming, ZHANG Bo. Value of an Dynamic Eye-tracking Task in Assessing Unilateral Spatial Neglect after Stroke [J]. Chinese General Practice, 2023, 26(32): 4020-4025.
[6]	JIAN Qiufeng, XU Ronghua, YAO Qian, ZHOU Yuanyuan. A Meta-analysis of the Prevalence and Influencing Factors of Post-stroke Cognitive Impairment in Chinese Elderly Patients [J]. Chinese General Practice, 2023, 26(32): 4070-4079.
[7]	LI Dongxu, SU Min, LIU Bin, ZHANG Tianjiao, ZHANG Weile. "Patients-centered" in the Reform of Public Primary Health Care Institutions: Does Doctor-patient Communication Improve the Quality of Primary Care Services? [J]. Chinese General Practice, 2023, 26(31): 3847-3855.
[8]	DUAN Yanqin, PENG Ying, LIU Shenglan, LIU Haijiao, YANG Huiqiong, HU Haiqing. Prevalence and Associated Factors of Potentially Inappropriate Medication among Elderly Outpatients [J]. Chinese General Practice, 2023, 26(31): 3902-3907.
[9]	ZHU Lin, GUO Yankui, GAO Chen, CHEN Xuezhi, WANG Fashuai. Efficacy of Western Medicine, Chinese Patent Medicine and Their Combination on Post-stroke Insomnia: a Network Meta-analysis [J]. Chinese General Practice, 2023, 26(30): 3823-3832.
[10]	XIAO Yuqian, BAI Yanjie, WANG Yan, CHEN Shuying, CHEN Limin, SUN Kexin, WAN Jun. Research Progress of Mitochondrial Transfer in Post-stroke Cognitive Impairment [J]. Chinese General Practice, 2023, 26(30): 3833-3840.
[11]	ZHOU Xiaoqi, LIU Xinhui, ZHANG Wei, LI Changfeng, YAN Yaqiong. Association of Alanine Transaminase and Aspartate Aminotransferase/Alanine Transaminase Ratio with Type 2 Diabetes and Metabolic Syndrome in the Elderly [J]. Chinese General Practice, 2023, 26(29): 3645-3649.
[12]	HUANG He, ZOU Zhizhuo, LI Qin, LIU Dong, WANG Yuqi, TAN Rongshao. Association between Calf Circumference and Sarcopenia in Kidney Transplant Recipients [J]. Chinese General Practice, 2023, 26(27): 3403-3410.
[13]	BAI Yitong, LIN Lianjie, PEI Dongmei. Correlation between the Severity of Metabolic-associated Fatty Liver Disease and Thyroid Nodules [J]. Chinese General Practice, 2023, 26(27): 3392-3396.
[14]	CHEN Weixiang, YIN Renlin, LING Lin, ZHANG Chi, JIANG Tingbo, LIN Jia. Correlation between C-reactive Protein to Albumin and Coronary Collateral Circulation in Patients with Unstable Angina Pectoris [J]. Chinese General Practice, 2023, 26(27): 3430-3434.
[15]	LIU Yue, LIU Qi, DONG Hui, LIU Yaling. Neuropsychological Changes of Cognitive Reverters after Stroke Based on the Montreal Cognitive Assessment (MoCA) with a Double Threshold [J]. Chinese General Practice, 2023, 26(27): 3417-3422.