老年心力衰竭患者发作期症状感知对短期健康结局的预测研究  

Prediction of short-term health outcomes in senile patients with heart failure by perception of symptoms during attack

作　　者：张静[1] 邬青[2] 李春[2] 严顾玥 Zhang Jing;Wu Qing;Li Chun;Yan Guyue(Department of Nursing,The Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]浙江大学医学院附属第二医院护理部,浙江杭州310009 [2]苏州大学附属第一医院护理部

出　　处：《护理学杂志》2025年第1期74-78,共5页Journal of Nursing Science

基　　金：国家自然科学基金项目(81700297);苏州大学附属第一医院院级科研项目(HLYJ-2024-02)。

摘　　要：目的探讨老年心力衰竭患者发作期症状感知对短期健康结局(再入院、死亡、生活质量)的影响和独立预测价值。方法通过便利抽样法,选取苏州2所医院750例老年心力衰竭患者为研究对象,收集患者人口学资料、临床资料及发作期症状感知水平。患者出院后进行为期6个月的随访。结果最终成功随访672例患者,发作期症状感知得分(43.11±8.69)分;随访期间,老年心力衰竭患者非计划性再入院150例(22.3%),死亡6例;6个月时生活质量的躯体健康、心理健康领域得分分别为(32.74±8.35)分、(42.78±5.89)分。发作期症状感知是出院后6个月生活质量躯体健康领域得分、6个月内再入院的危险因素(均P<0.05)。发作期症状感知对老年心力衰竭患者再入院风险的预测效能显著高于左心室射血分数(P<0.05),其最佳临界值为46.5分,ROC曲线下面积为0.765。结论发作期症状感知可预测老年心力衰竭患者短期内生活质量及再入院风险。建议医护人员指导患者及时准确地监测症状,以有效降低再入院率,改善疾病康复效果及生活质量。Objective To investigate the influence and independent predictive value of symptom perception on short-term outcomes(readmission,death,quality of life)in elderly patients with heart failure.Methods A total of 750 elderly patients with heart failure from 2 hospitals in Suzhou were selected by convenience sampling method.Demographic data,clinical data and perception of symptoms during attack were collected.Patients were followed up for 6 months after discharge,and readmissions and deaths within 6 months and quality of life at 6 months were collected.Results Finally,672 patients were successfully followed up,and the symptom perception score during attack was(43.11±8.69).During the follow-up period,150 cases(22.3%)of elderly patients with heart failure were readmitted and 6 cases died.At 6 months,quality of life scores of physical health component and mental health component were(32.74±8.35)points and(42.78±5.89)points,respectively.Symptom perception during heart failure acute phase was a risk factor for quality of life of physical health domain at 6 months after discharge,and for readmission at 6 months after discharge(both P<0.05).The predictive efficacy of symptom perception to predict readmission risk in elderly heart failure patients was significantly higher than that of left ventricular ejection fraction(P<0.05).The optimal critical value was 46.5 points and the area under the ROC curve was 0.765.Conclusion The perception of symptoms during attack can predict short-term readmission and quality of life in elderly patients with heart failure,especially the prediction of readmission is better than left ventricular ejection fraction.It is suggested that medical staff should guide patients to monitor their symptoms timely and accurately,in an effort to effectively reduce the readmission rate and improve the effect of rehabilitation treatment.

关 键 词：老年人 心力衰竭 症状 症状感知 随访 生活质量 再入院 预后 

分 类 号：R473.5[医药卫生—护理学] R541.6[医药卫生—临床医学]