老年慢性心力衰竭患者自我管理轨迹及其影响因素分析  

Self-management trajectories and influencing factors of older patients with Chronic Heart Failure

作　　者：王斐 丁雯 刘娟[3] 姚丽[3] 孙爱萍 康文娟 WANG Fei;DING Wen;LIU Juan;YAO Li;SUN Aiping;KANG Wenjuan(Department of Cardiovascular Medicine,Weifang Medical College Affiliated Hospital,Weifang,Shandong province,261035,China)

机构地区：[1]潍坊医学院附属医院心内科,山东省潍坊市261035 [2]宁夏医科大学总医院护理部 [3]宁夏医科大学总医院心内科 [4]空军军医大学附属第二医院军队人员医疗保健中心 [5]宁夏医科大学总医院心脑血管病医院呼吸与危重症医学科

出　　处：《中国护理管理》2024年第9期1308-1313,共6页Chinese Nursing Management

基　　金：宁夏自然科学基金项目(2022AAC03514);宁夏回族自治区重点研发计划项目(2022BEG03093)。

摘　　要：目的:识别老年慢性心力衰竭患者自我管理轨迹,分析不同轨迹的预测因素,为制定具有针对性的干预措施提供参考。方法:采用便利抽样法,选取2021年12月至2022年6月在银川市某三级甲等医院心内科病房住院的213例老年慢性心力衰竭患者为研究对象,于住院期间进行首次调查,于出院后1个月、3个月、6个月及12个月时进行随访调查。采用潜类别增长模型识别患者自我管理行为轨迹的类别,并采用多元Logistic回归分析不同类别轨迹的预测因素。结果:共173例患者完成全部随访调查,通过潜类别增长模型识别出3条老年慢性心力衰竭患者自我管理轨迹,分别为“低水平-下降”(29.5%)、“中等水平-维持”(39.9%)、“高水平-上升”(30.6%),多元Logistic回归分析结果显示:社会支持、慢性病管理自我效能、个人月收入、居住地、性别是老年慢性心力衰竭患者自我管理轨迹的影响因素(P<0.05)。结论:老年慢性心力衰竭患者自我管理呈现不同的轨迹,应根据患者自我管理轨迹特点,制定有针对性的干预措施,以帮助患者维持良好的自我管理行为。Objective:To identify the self-management trajectories of older patients with Chronic Heart Failure(CHF)and to analyze the predictive factors of different trajectories.Methods:A convenience sampling was used to recruit 213 older patients with CHF who were hospitalized in a cardiology ward of a tertiary grade A hospital in Yinchuan from December 2021 to June 2022.The first questionnaire survey was conducted during hospitalization,and follow-up surveys were conducted 1 month,3 months,6 months and 12 months after discharge.A latent class growth model was used to identify different categories of patients'self-management behavior change.Multiple Logistic regression was used to analyze the predictors of trajectory categories.Results:Totally 173 patients completed the all follow-up surveys.Three self-management trajectories of older patients with CHF were identified,namely"low level-declining"(29.5%),"moderate level-maintaining"(39.9%),and"high level-increasing"(30.6%).The results of multiple Logistic regression analysis showed that social support,self-efficacy,personal monthly income,place of residence,and gender were factors influencing the trajectory of self-management in older patients with CHF(P<0.05).Conclusion:Older patients with CHF shows different trajectories of self-management.Targeted measures should be developed based on the characteristics of patients'self-management trajectories to help patients maintain good self-management behaviors.

关 键 词：慢性心力衰竭 自我管理 轨迹 潜类别增长模型 纵向研究 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]