目的 初步构建脑卒中患者与照顾者二元自我护理交互理论模型，为脑卒中自我护理干预提供指导框架。方法 遵循护理学科理论模型发展过程，综合采用文献研究、质性研究及理论分析，初步构建脑卒中患者与照顾者二元自我护理交互理论模型。结果 模型显示，脑卒中患者与照顾者二元自我护理分为患者主导型、照顾者主导型、二元共赢型和二元矛盾型4种类型。影响因素包括患者与照顾者的一般特征、患者因素、照顾者因素、二元因素和环境因素。患者因素、照顾者因素、二元因素可交互影响二元自我护理，自我效能在其他患者因素、照顾者因素、二元因素和二元自我护理之间起中介作用。结论 该模型明确了脑卒中患者与照顾者二元自我护理的类型，梳理了其与影响因素的关系，可为干预靶点因素的选取提供参考。

Objective To preliminarily construct a theoretical model of dyadic self-care interaction between stroke patients and caregivers,and to provide a guiding framework for stroke self-care interventions.Methods Following the development process of the nursing theoretical model, a theoretical model of dyadic self-care interaction between stroke patients and caregivers was initially constructed by comprehensively adopting literature research, qualitative research and theoretical analysis.Results The model showed that the dyadic self-care of stroke patients and caregivers was divided into four types:patient-dominated type,caregiver-dominated type,dyadic win-win type and dyadic contradictory type.The influencing factors included the general characteristics of patients and caregivers,patient factors,caregiver factors,dyadic factors and environmental factors.Patient factors,caregiver factors and dyadic factors could interactively affect dyadic self-care,and self-efficacy played a mediating role among other patient factors,caregiver factors,dyadic factors and dyadic self-care.Conclusions This model clarifies the types of dyadic self-care between stroke patients and caregivers and the relationship between dyadic self-care and its influencing factors,which provides a reference for selecting target factors for interventions.

R473.74

国家自然科学基金面上项目（72174184）；河南省高等学校重点科研项目（26B320026）