疾病感知控制、运动自我效能对心力衰竭患者运动恐惧影响的纵向研究  

Effects of perceived disease control and exercise self-efficacy on kinesiophobia in patients with heart failure: a longitudinal study

作　　者：王艳玲 常淑莹 李红 阚亦非 张楠楠 Wang Yanling;Chang Shuying;Li Hong;Kan Yifei;Zhang Nannan(International Medical Center of Henan Provincial People′s Hospital,Henan Key Laboratory of Nursing Medicine,People′s Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院国际医疗中心河南省护理医学重点实验室郑州大学人民医院国际医疗中心,郑州450003

出　　处：《中国实用护理杂志》2022年第23期1782-1789,共8页Chinese Journal of Practical Nursing

基　　金：河南省医学科技攻关计划项目 (LHGJ 20200028)。

摘　　要：目的探讨心力衰竭患者出院过渡期的运动恐惧现状,分析其变化趋势及影响因素。方法便利抽取2020年2月至2021年4月在河南省人民医院收治的189例心力衰竭患者为研究对象,采用一般情况调查表、心脏病患者运动恐惧量表、中文版运动自我效能量表和修订版控制态度量表对患者出院前2~3 d、出院后1个月和4个月进行调查。结果患者运动恐惧得分从出院前2~3 d[(48.62±11.26)分]到出院后1个月[(49.03±11.24)分]稍有恶化,随着时间延长到出院后4个月[(47.86±11.11)分]而降低,总体表现出改善趋势,差异有统计学意义(F=17.92,P<0.01);疾病感知控制得分也表现出相同的变化趋势,出院前2~3 d(27.34±7.40)分、出院后1个月(26.18±7.39)分、出院后4个月(27.76±7.38)分,差异有统计学意义(F=38.41,P<0.01),出院后4个月[(35.63±11.51)分]的运动自我效能得分高于出院前2~3 d[(34.00±11.88)分]以及出院后1个月[(34.20±11.69)分],差异有统计学意义(F=12.33,P<0.01)。广义估计方程显示,运动自我效能(B=-0.255,P<0.01)及疾病感知控制(B=-0.439,P<0.01)是心力衰竭患者运动恐惧的保护性因素。路径分析表明,疾病感知控制既可直接预测患者运动恐惧(β=-0.461,P<0.01),也可通过作用于运动自我效能间接影响患者运动恐惧(中介效应=-0.21,95%CI-0.293~-0.136),中介效应占总效应的31%。结论心力衰竭患者出院过渡期运动恐惧、疾病感知控制和运动自我效能呈动态变化,疾病感知控制既可直接预测患者运动恐惧,也可以通过作用于运动自我效能间接影响其运动恐惧。护理人员可制订基于感知控制或自我效能的护理干预,改善心力衰竭患者运动恐惧水平。Objective To explore the status of kinesiophobia in patients with heart failure during discharge transition period,and analyze its changing trend and influencing factors.Methods The189 patients with heart failure treated in Henan Provincial People′s Hospital from February 2020 to April 2021 were conveniently selected as the research objects.The general situation questionnaire,the Tampa Scale for Kinesiophobia Heart,the Self-efficacy for Exercise Scale and the Control Attitudes Scale-Revised were used to investigate the patients 2-3 days before leaving the hospital,1 month and 4 months after discharge.Results The score of patients′kinesiophobia deteriorated slightly from 2-3 days before discharge(48.62±11.26)to 1 month after discharge(49.03±11.24),and decreased with the extension of the transition time to 4 months after discharge(47.86±11.11).The overall trend of improvement was statistically significant(F=17.92,P<0.01).The score of perceived disease control also showed the same change pattern,2-3 days before discharge(27.34±7.40),1 month after discharge(26.18±7.39),4 months after discharge(27.76±7.38),the difference was statistically significant(F=38.41,P<0.01).The score of the exercise self-efficacy of 4 months after discharge(35.63±11.51)was higher than(34.00±11.88)of 2-3 days before discharge and(34.20±11.69)of 1 month after discharge(F=12.33,P<0.01).The generalized estimation equation showed that exercise self-efficacy(B=-0.255,P<0.01)and perceived disease control(B=-0.439,P<0.01)were protective factors of kinesiophobia in patients with heart failure.Path analysis showed that perceived disease control could not only directly predict patients′kinesiophobia(β=-0.461,P<0.01),but also indirectly affect patients′kinesiophobia by acting on exercise self-efficacy(mediating effect=-0.21,95%CI-0.293--0.136).The mediating effect accounted for 31%of the total effect.Conclusions The kinesiophobia,perceived disease control and exercise self-efficacy in patients with heart failure during discharge transit

关 键 词：心力衰竭 出院过渡期 运动恐惧 疾病感知控制 运动自我效能 

分 类 号：R473.5[医药卫生—护理学]