健康生态学视角下慢性心力衰竭患者自我护理现状及影响因素分析  

Self-care status and influencing factors in patients with chronic heart failure from perspectives of health ecology

作　　者：郝天天 徐翠荣[2] 徐筱璐 HAO Tiantian;XU Cuirong;XU Xiaolu(Department of Cardiology,Yangzhou Hospital of Traditional Chinese Medicine,Yangzhou Jiangsu 225127;Nursing Department,Zhongda Hospital Affiliated to Southeast University,Nanjing Jiangsu 210009;Department of Plastic and Maxillofacial Surgery,Affiliated Stomatological Hospital of Nanjing Medical University,Nanjing Jiangsu 210009,China)

机构地区：[1]扬州市中医院心内科,江苏扬州225127 [2]东南大学附属中大医院护理部,江苏南京210009 [3]南京医科大学附属口腔医院整形颌面外科,江苏南京210009

出　　处：《实用心电与临床诊疗》2025年第1期120-126,共7页PRACTICAL ELECTROCARDIOLOGY AND CLINICAL TREATMENT

基　　金：江苏省重点研发计划(社会发展)项目(BE2019746);江苏省卫健委医学科研立项重点项目(ZD2022057)。

摘　　要：目的基于健康生态学视角,分析慢性心力衰竭(简称心衰)患者自我护理水平的影响因素。方法采用便利抽样法,选取东南大学附属中大医院“医联体”社区卫生服务中心的231例慢性心衰患者为研究对象。以健康生态学为影响因素分类理论框架,从个人特质、行为方式、人际网络、工作与生活环境、政策层面,使用一般资料调查表、心衰自我护理指数量表、社会支持评定量表、广泛性焦虑障碍7项量表、患者健康问卷抑郁量表进行调查,运用单因素分析和线性回归分析探讨影响因素。结果慢性心衰患者整体自我护理水平不高,自我护理平均总得分为(46.73±8.29)分。线性回归分析显示,个人特质层面的左心室射血分数(LVEF),行为方式层面的焦虑、抑郁、知识获取途径数,人际网络层面的社会支持水平是慢性心衰患者自我护理水平的独立影响因素(P<0.05),共可解释64.5%的自我护理水平变化。结论慢性心衰患者自我护理能力仍需加强。护理人员应关注健康生态学视角下慢性心衰患者自我护理水平的影响因素,从多维度、多层面对患者进行系统化干预,以增强患者的自我护理能力。Objective Based on the perspective of health ecology,to analyze the influencing factors of self-care level in patients with chronic heart failure(CHF).Methods A total of 231 patients with CHF were selected from the community health service centers of medical association of Zhongda Hospital Affiliated to Southeast University by convenience sampling method.Health ecology was used as the theoretical framework of influencing factors classification.In terms of personal characteristics,behavior style,interpersonal network,working and living environments,and policy aspects,we used the general information questionnaire,self-care of heart failure index(SCHFI),social support rating scale(SSRS),7-item generalized anxiety disorder scale(GAD-7),and patient health questionnaire-9(PHQ-9)to perform investigation.Univariate analysis and linear regression analysis were used to explore the influencing factors.Results The overall self-care level of patients with CHF was not high,and the average total score of self-care was(46.73±8.29)points.Linear regression analysis showed that LVEF at the level of individual characteristics,anxiety,depression and the number of knowledge acquisition pathways at the level of behavior style,and the level of social support at the interpersonal network level were independent influencing factors for self-care level in patients with CHF(P<0.05),which could explain 64.5%of the variation in self-care level.Conclusion The self-care ability of patients with CHF still needs to be strengthened.Nursing staff should pay attention to the influencing factors of self-care level of CHF patients from the perspective of health ecology,and should give systematic intervention from multi-dimensions and multi-layers,so as to enhance the selfcare ability of patients.

关 键 词：健康生态学 慢性心力衰竭 自我护理 影响因素 

分 类 号：R541.6[医药卫生—心血管疾病]