心脏机械瓣膜置换术后患者生存质量与自我管理行为研究  

Study on Quality of Life and Self-management Behavior of Patients Following Mechanical Heart Valve Replacement

作　　者：温雅[1] 龚仁蓉[2] 白阳静[3] 蒋晓莲[4] 

机构地区：[1]四川大学华西医院心血管内科,成都610041 [2]四川大学华西医院手术室,成都610041 [3]四川大学华西医院心脏大血管外科,成都610041 [4]四川大学华西护理学院,成都610041

出　　处：《华西医学》2016年第11期1864-1868,共5页West China Medical Journal

基　　金：四川省科技厅科技支撑计划项目(2013SZ0089)~~

摘　　要：目的描述心脏机械瓣膜置换术后患者生存质量及自我管理行为现状,探索二者之间的相互关系。方法采用便利抽样法选取2011年1月-2012年6月成都市某三级甲等医院心脏机械瓣膜置换者352例,调查工具包括一般资料问卷、简明健康调查问卷(MOS SF-36)、心脏瓣膜置换手术自我管理行为量表。采用t检验将MOS SF-36问卷结果与四川省常模比较,采用Pearson相关分析生存质量与自我管理行为之间的相关性。结果 1心脏瓣膜置换术后1年内患者MOS SF-36得分生理机能(73.44±15.11)分,生理职能(49.52±39.17)分,躯体疼痛(63.13±17.93)分,总体健康(58.85±14.88)分,活力(63.54±18.10)分,社会功能(76.67±17.40)分,情感职能(64.96±41.37)分,精神健康(72.76±17.40)分;与四川省常模相比,除精神健康外其他7个维度得分均低于常模(P<0.05);术后1年以上者生理机能(76.53±14.41)分,生理职能(58.44±39.21)分,躯体疼痛(68.16±18.26)分,总体健康(61.39±13.57)分,活力(68.47±16.37)分,社会功能(79.79±19.34)分,情感职能(72.94±37.29)分,精神健康(75.87±14.70)分,生理机能、躯体疼痛、总体健况、社会功能、情感职能得分低于常模(P<0.05)。2自我管理行为总分平均分(143.21±20.63)分。3自我管理行为与术后生存质量呈不同程度的正相关。结论心脏机械瓣膜置换者术后生存质量较正常人仍有差距,生存质量与自我管理行为呈正相关,较好的自我管理行为有助于提高机械瓣膜置换者术后生存质量。ObjectiveTo describe the status of quality of life （QOL） and self-management behavior in patients following mechanical heart valve replacement, and explore the relationship between QOL and self-management behavior. MethodsConvenient sampling was used to recruit 352 patients following mechanical heart valve replacement in a high-level hospital in Chengdu between January 2011 and June 2012. General information questionnaire, MOS SF-36 scales, and self-management behavior questionnaire were used to collect data. T-test was used to analyze the difference between patients and normal people. And correlation analysis was used to see the correlation between QOL and self-management. ResultsFor MOS SF-36 scale results in patients within one year after surgery, physical functioning （PF） score was 73.44±15.11, role-physical （RP） was 49.52±39.17, body pain （BP） was 63.13±17.93, general health （GH） was 58.85±14.88, vitality （VT） was 63.54±18.10, social functioning （SF） was 76.67±17.40, role-emotional （RE） was 64.96±41.37, and mental health （MH） was 72.76±17.40. All these scores of the patients were significantly lower than the norm of Sichuan Province （P〈0.05） except the dimension of mental health. For patients one year or more after surgery, PF score was 76.53±14.41, RP 58.44±39.21, BP 68.16±18.26, GH 61.39±13.57, VT 68.47±16.37, SF 79.79±19.34, RE 72.94±37.29, and MH 75.87±14.70, among which PF, RE, BP and GH scores were lower than the norm （P〈0.05）. The average total score of self-management behavior was 143.21±20.63. QOL and self-management behavior were positively correlated. ConclusionThere is still a gap between patients following mechanical heart valve replacement and normal people in terms of quality of life. Patients＇ self-management behavior is positively correlated with the quality of life. Good self-management behavior contributes to the improvement of QOL.

关 键 词：心脏机械瓣膜置换 生存质量 自我管理行为 

分 类 号：R473.6[医药卫生—护理学]