经皮冠状动脉介入治疗术后患者运动恐惧的发展轨迹及影响因素  

The developmental trajectory and influencing factors of kinesiophobia among post-percutaneous coronary intervention patients

作　　者：夏锐南 王瑞 张俊峰 邹小芳[4] 邹润凤 Xia Ruinan;Wang Rui;Zhang Junfeng;Zou Xiaofang;Zou Runfeng(School of Nursing,Guangdong Pharmaceutical University,Guangzhou 510315,China;Nursing Department,Traditional Chinese Medical Hospital of Huangpu District,Guangzhou 510700,China;Department of Nursing,Songshan Lake Central Hospital of Dongguan City,Dongguan 525526,China;Nursing Department,Guangdong Provincial Key Laboratory of Major Obstetric Diseases,Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology,the Third Affiliated Hospital,Guangzhou Medical University,Guangzhou 510150,China;Department of Cardiovascular Care,Guangdong Provincial Key Laboratory of Major Obstetric Diseases,Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology,the Third Affiliated Hospital,Guangzhou Medical University,Guangzhou 510150,China)

机构地区：[1]广东药科大学护理学院,广州510315 [2]广州市黄埔区中医医院护理部,广州510700 [3]东莞市松山湖中心医院护理部,东莞525526 [4]广东省产科重大疾病重点实验室,广东省妇产疾病临床医学研究中心,广州医科大学附属第三医院护理部,广州510150 [5]广东省产科重大疾病重点实验室,广东省妇产疾病临床医学研究中心,广州医科大学附属第三医院心血管监护室,广州510150

出　　处：《中华行为医学与脑科学杂志》2025年第1期43-50,共8页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：广东省医学科研基金(A2022397)。

摘　　要：目的探讨经皮冠状动脉介入治疗(PCI)患者术后4个月的运动恐惧变化轨迹及影响因素。方法2022年3月至2023年7月,采用便利抽样法,选取广东省两所三甲医院心内科行PCI的217名患者作为调查对象。采用一般资料调查表、心脏病患者运动恐惧量表,在患者出院前1 d、出院2周、出院1个月、出院4个月4个时间点进行调查。采用SPSS 25.0和Mplus 8.7软件进行数据分析。采用增长混合模型、卡方检验、多项式Logistic回归进行数据处理分析。结果PCI患者术后4个月的运动恐惧轨迹存在3个潜在类别,分别为持续高运动恐惧组[22.6%(49/217)]、中水平运动恐惧快速下降组[47.4%(103/217)]、运动恐惧快速下降-升高组[30.0%(65/217)]。多项式Logistic回归分析显示,与中水平运动恐惧快速下降组相比,女性患者(B=1.136,OR=3.113,95%CI=1.155~8.389)、心功能Ⅱ级以上患者(B=1.135,OR=3.112,95%CI=1.380~7.017)更倾向于发展为持续高运动恐惧组;与运动恐惧快速下降-升高组相比,心功能Ⅱ级以上患者(B=3.322,OR=27.712,95%CI=5.251~146.244)、冠心病确诊病程>2年的患者(B=3.855,OR=47.250,95%CI=2.146~1040.535)更倾向于发展为持续高运动恐惧组;与运动恐惧快速下降-升高组相比,心功能Ⅱ级以上患者(B=-2.187,OR=0.112,95%CI=0.022~0.565)、共病≥3种的患者(B=-2.711,OR=0.066,95%CI=0.008~0.528)、冠心病确诊病程>2年的患者(B=-2.376,OR=0.093,95%CI=0.011~0.783)更倾向于发展为中水平运动恐惧快速下降组。结论PCI术后患者4个月内的运动恐惧水平呈曲线下降,运动恐惧发展轨迹存在异质性;性别、心功能、冠心病确诊病程、共病情况影响不同亚组发展轨迹。ObjectiveTo explore the developmental trajectory and influencing factors of kinesiophobia in patients undergoing percutaneous coronary intervention(PCI).MethodsBy convenient sampling,totally 217 patients undergoing PCI who enrolled from two tertiary hospitals in Guangdong Province from March 2022 to July 2023.The demographic data of the patients was collected,and kinesiophobia was measured using the Tampa scale for kinesiophobia heart(TSK-SV-Heart)at one day pre-discharge,2 weeks,1 month,and 4 months post-discharge.Data analysis was conducted using SPSS 25.0 and Mplus 8.7 softwares.Growth mixture modelling,chi-square test,and polynomial Logistic regression were used for data processing and analysis.ResultsThree different kinesiophobia trajectory classes were identified in patients within 4 months after PCI:sustained high level of kinesiophobia group(C1 group,22.6%(49/217)),moderate level of kinesiophobia with a rapid decrease group(C2 group,47.4%(103/217)),and rapid decrease of kinesiophobia followed an increase group(C3 group,30.0%(65/217)).Polynomial Logistic regression results showed that,females(B=1.136,OR=3.113,95%CI=1.155-8.389),patients with NYHAⅡ/Killip classⅡor above(B=1.135,OR=3.112,95%CI=1.380-7.017)were more likely to develop into the C1 compared with the C2 group.Compared with the C3 group,patients with NYHAⅡ/Killip classⅡor above(B=3.322,OR=27.712,95%CI=5.251-146.244),and patients with coronary heart disease(CHD)more than two years(B=3.855,OR=47.250,95%CI=2.146-1040.535)were more likely to develop into the C1 group.Compared with the C3 group,patients with NYHAⅡ/Killip classⅡor above(B=-2.187,OR=0.112,95%CI=0.022-0.565),patients with three or more comorbidities(B=-2.711,OR=0.066,95%CI=0.008-0.528),and patients with CHD more than two years(B=-2.376,OR=0.093,95%CI=0.011-0.783)were more likely to develop into the C2 group.ConclusionKinesiophobia level in patients undergoing PCI presents a curvilinear decrease within 4 months after PCI.Different kinesiophobia trajectory classes can be observe

关 键 词：冠心病 经皮冠状动脉介入 运动恐惧 纵向研究 增长混合模型 

分 类 号：R473.5[医药卫生—护理学]