慢性心力衰竭患者症状群特征及其对生活质量的影响  

Characteristics of symptom clusters in patients with chronic heart failure and their impact on quality of life

作　　者：张蓉 徐亚萍 张楚研 王慧 海瑞 杨益[2] ZHANG Rong;XU Yaping;ZHANG Chuyan;WANG Hui;HAI Rui;YANG Yi(School of Nursing,Xinjiang Medical University,Urumqi,Xinjiang 830000,China;Department of Nursing,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,China)

机构地区：[1]新疆医科大学护理学院,乌鲁木齐830000 [2]新疆医科大学第一附属医院护理部,乌鲁木齐830054

出　　处：《重庆医学》2023年第12期1839-1844,1851,共7页Chongqing medicine

基　　金：新疆维吾尔自治区研究生科研创新项目(XJ2021G230)。

摘　　要：目的探讨慢性心力衰竭患者症状群内部特征,并分析其对生活质量的影响。方法采用便利抽样法,选取中文版多维度疲劳量表(MFI-20)、匹兹堡睡眠质量指数(PSQI)、肺功能状态与呼吸困难问卷修订版(PFSDQ-M)、明尼苏达心力衰竭生活质量调查问卷(MLHFQ)对新疆某三级甲等医院210例慢性心力衰竭患者进行调查。结果根据患者MFI-20、PSQI、PFSDQ-M得分进行聚类分析,最终分为低症状组(n=121)和高症状组(n=89)两个亚组。两组患者在性别、饮酒史、年住院次数、吸烟史、纽约心脏病协会心功能分级、合并症数量、高血压史、MLHFQ、PFSDQ-M、PSQI、MFI-20得分上比较差异有统计学意义(P<0.05)。二元logistic回归分析结果显示:心功能分级、性别、合并症数量是高症状组的预测指标(P<0.05)。分层回归分析结果显示:症状群内各症状、症状群亚组对慢性心力衰竭患者生活质量的影响差异有统计学意义(P<0.001),可解释慢性心力衰竭患者生活质量总体水平变异的55.5%。结论从症状群的角度出发,及时对高危人群进行症状识别与管理,以减轻症状负担,改善患者的生活质量,为实现科学有效的症状管理模式提供依据。Objective To investigate the internal characteristics of core symptom clusters in patients with chronic heart failure,and to analyze their impact on quality of life.Methods A convenience sampling method was used to select 210 patients with chronic heart failure in a tertiary hospital in Xinjiang,and the pulmonary function status and dyspnea questionnaire(PFSDQ-M),Pittsburgh sleep quality index(PSQI),Chinese version of the multidimensional fatigue scale(MFSI-SF)were used to investigate.Results Cluster analysis was performed according to the patients’symptom scores,and the patients were finally divided into the low symptom group(121 cases)and the high symptom group(89 cases).There were differences in gender,drinking history,annual hospitalization times,smoking history,NYHA classification,number of comorbidities,history of hypertension,MLHFQ,PFSDQ-M,PSQI,and MFSI-SF scores between the two groups(P<0.05).Cardiac function class,gender,and number of comorbidities were important influencing factors of symptom clusters.There were statistically significant differences in the influence of each symptom in the symptom clusters and the subgroup of the symptom clusters on the quality of life of patients with chronic heart failure(P<0.001).Conclusion From the perspective of symptom clusters,timely identification and management of symptoms in high-risk groups can reduce the burden of symptoms,improve the quality of life of patients,and provide ideas for precise nursing strategies.

关 键 词：慢性心力衰竭 症状群 生活质量 症状管理 预测指标 

分 类 号：R541.6[医药卫生—心血管疾病]