探究冠状动脉支架术后患者健康相关症状的异质性分类及预测因素  

To explore the heterogeneous classification of health-related symptoms and predictive factors in patients receiving coronary artery stent implantation

作　　者：王琪 何芷晴 徐超玥 张华语 阳晶 黄延锦[1,3] WANG Qi;HE Zhiqing;XU Chaoyue;ZHANG Huayu;YANG Jing;HUANG Yanjin(School of Nursing,University of South China,Hengyang 421001,Hunan,China;The Second Affiliated Hospital of University of South China,Hengyang 421001,Hunan,China;School of Nursing,Fudan University,Shanghai 200032,China)

机构地区：[1]南华大学护理学院,湖南衡阳421001 [2]南华大学附属第二医院,湖南衡阳421001 [3]复旦大学护理学院,上海200032

出　　处：《护士进修杂志》2024年第13期1355-1361,共7页Journal of Nurses Training

基　　金：南华大学护理学院研究生科研创新项目(编号:2023CXKT006)。

摘　　要：目的探讨冠状动脉支架术后患者的症状分布特征,并分析高症状负担人群的预测因素。方法于2023年3-5月采用便利抽样的方法,选取湖南省衡阳市某2所三级甲等综合医院接受冠状动脉支架术的366例冠心病患者为研究对象。使用患者报告结局测量信息系统(patient-repotred outcomes measurement information system,PROMIS)特征集进行调查,应用潜在类别分析(latent class analysis,LCA)、单因素分析、logistic回归分析确定术后患者症状的特征分类,并探索各类别的区分因素。结果LCA结果表明,冠状动脉支架术后患者的健康相关症状存在3个潜在类别,分别为高心理症状组(33%)、低症状组(48.1%)、高生理症状组(18.9%)。不同类别患者在身体功能、社会功能、疼痛强度上的差异有统计学意义(P<0.05)。年龄、文化程度、心功能水平、合并其他慢性病状况及支架植入个数是预测冠状动脉支架术后患者症状类别的重要因素(P<0.05)。结论冠状动脉支架术后患者存在3种类别的症状特征,照护时可依据区分3类别的预测因素对患者精准识别,有效管理。且3组患者的身体功能均有一定程度受限,以高生理症状组尤其明显;高心理症状组需重点关注其社会功能。Objective To explore the distribution of symptom features among coronary artery stent implantation patients,and analyze the predictive factors of high symptom burden patients.Methods From March to May 2023,a total of 366 patients with coronary heart disease who underwent coronary artery stent implantation in 2 tertiary hospitals in Hengyang city of Hunan province were selected as the study object by convenience sampling method.General information questionnaire and patient-reported outcomes measurement information system(PROMIS-57)were used for investigation,and latent class analysis(LCA),univariate analysis,and logistic regression analysis were used to determine the characteristic classification of post-stenting symptoms in patients and explore the distinguishing factors of each category.Results The results of LCA showed that 3 latent categories of health-related symptoms in post-stenting patients were identified,which were high psychological symptom group(33%),low symptom group(48.1%),and high physiological symptom group(18.9%).There were significant differences in physical function,social function,and pain intensity among patients in different categories(P<0.05).Age,education level,cardiac function level,presence of comorbidities,and the number of stents implanted were important factors in predicting the symptom category of post-stenting patients(P<0.05).Conclusion There are 3 categories of symptom features in post-stenting patients,which can be accurately identified and effectively managed based on the predictive factors distinguishing 3 categories.The physical function of 3 groups of patients is limited to some extent,especially in the high physiological symptom group,while the high psychological symptom group needs to pay special attention to their social function.

关 键 词：冠心病 冠状动脉支架术 患者报告结局 症状管理 潜在类别分析 

分 类 号：R473.54[医药卫生—护理学]