慢性心力衰竭患者自我管理及社会经济影响研究  

Research on Socioeconomic Impact of Self-management in Patients with Chronic Heart Failure

作　　者：苏蓉[1] 林玲[1] 杨爱玲[1] 张明国[1] 李云飞[1] 梁娅莎 SU Rong;LIN Ling;YANG Ailing;ZHANG Mingguo;LI Yunfei;LIANG Yasha(Dept.of Geriatric Cardiology,The 1st Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650500,China)

机构地区：[1]昆明医科大学第一附属医院老年心脏内科,云南昆明650500

出　　处：《昆明医科大学学报》2024年第9期76-82,共7页Journal of Kunming Medical University

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目[2019FE001(-033)];云南省老年疾病临床医学研究中心-老年共病诊疗及临床转化研究项目(202102AA310069)。

摘　　要：目的了解慢性心衰(chronic heart failure,CHF)患者的自我管理及社会经济影响。方法2019年9月至2023年5月采用方便抽样方法调查分析云南省1762名18~89岁CHF患者出院1个月后的自我管理情况。运用主成分分析方法构建综合性社会经济地位,运用二分类Logistic回归分析方法探讨CHF患者自我管理的社会经济影响。结果CHF患者的运动管理、监测症状/体重、遵医嘱用药、低钠饮食、控制液体或水摄入及定期随访的比例分别是29.2%、37.7%、80.9%、58.0%、3.3%和45.5%;不同性别患者的运动管理和低钠饮食的比例不同(P<0.05);与年龄较小的患者相比,年龄较大的患者遵医嘱用药、监测症状/体重及低钠饮食的比例更高(P<0.05);而受教育程度及收入越高的患者,遵医嘱用药、运动管理、监测症状/体重及定期随访的比例也较高(P<0.01);非务农的患者在遵医嘱用药、运动管理、监测症状/体重及定期随访的比例高于务农患者(P<0.01)。Logistic回归分析结果显示,遵医嘱服药、监测症状/体重、运动管理和定期随访都是社会经济地位越高,自我管理越好(P<0.05)。结论云南省CHF患者的自我管理水平总体较低,且存在社会经济影响,改善CHF患者的自我管理水平,应重点关注低社会经济地位患者。Objective To investigate the socioeconomic impact of self-management in patients with chronic heart failure(CHF).Methods Convenient sampling method was used to investigated and analyzed the selfmanagement of 1762 CHF patients aged 18~89 one month after discharge in Yunnan Province from September 2019 to May 2023.Principal component analysis method was used to construct comprehensive socioeconomic status(SES),and binary Logistic regression analysis was used to investigate the socioeconomic impact of self-management in patients with CHF.Results The proportions of exercise management,monitoring symptom/weight,medication as prescribed,low sodium diet,fluid or water intake control and regular follow-up were 29.2%,37.7%,80.9%,58.0%,3.3%and 45.5%in patients with CHF,respectively.The proportion of exercise management and low sodium diet was different in different gender patients(P<0.01).Compared with young patients,older ones were more likely to follow prescribed medication,monitor symptoms or weight,and eat a low-sodium diet.Patients with higher education and income were also more likely to follow prescribed medication,exercise management,monitoring symptoms or weight,and regularly follow-up.Non-farmer patients had higher rates of prescribed medication,exercise management,monitoring of symptoms or weight,and regular follow-up than farmer patients.The binary logistic regression analysis results showed that a higher proportion of prescribed medication,monitoring of symptoms/weight,exercise management,and regular follow-up was found in the higher SES(P<0.05).Conclusion The self-management of CHF patients is generally low,and there are socioeconomic effects.Improving self-management in patients with CHF should focus on patients with low socioeconomic status.

关 键 词：慢性心力衰竭 自我管理 社会经济地位 

分 类 号：R541.61[医药卫生—心血管疾病]