心脏影响否认在老年PCI术后患者感知心脏康复障碍与心脏康复依从性间的中介效应  

Mediating effect of cardiac impact denial between perceived cardiac rehabilitation barriers and cardiac rehabilitation adherenceinelderlypatients after PCI

作　　者：孙莲莲[1] 黄赛燕 李文玉[1] 洪彩霞 陈秀青[1] Sun Lianlian;Huang Saiyan;Li Wenyu;Hong Caixia;Chen Xiuqing(Department of Cardiovascular,the First Hospital of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第一医院心血管内科,温州325000

出　　处：《中华现代护理杂志》2025年第12期1563-1568,共6页Chinese Journal of Modern Nursing

基　　金：浙江省卫生健康科技计划项目(2022KY892);温州市基础性公益科研项目(Y20220592)。

摘　　要：目的探讨感知心脏康复障碍对老年经皮冠状动脉介入治疗(PCI)术后患者心脏康复依从性的影响及心脏影响否认的中介效应。方法本研究为横断面研究。选取2023年8月-2024年7月在温州医科大学第一附属医院行PCI出院后需要接受Ⅱ期心脏康复的336例老年患者为研究对象。采用一般资料调查问卷、冠心病患者心脏康复依从性评价量表(ACRAS-CHD)、心脏康复障碍量表(CRBS)、心脏影响否认量表(CDIS)对患者进行调查。采用Bootstrap法抽样5000次进行中介效应检验。结果本研究共发放问卷336份,回收有效问卷324份,问卷有效回收率为96.43%(324/336)。324例老年PCI术后患者ACRAS-CHD得分为(73.19±5.46)分,CRBS得分为(79.35±6.60)分,CDIS得分为(30.57±3.66)分。感知心脏康复障碍对老年PCI术后患者心脏康复依从性的直接效应为-0.368,占总效应的74.49%(-0.368/-0.494);心脏影响否认在老年PCI术后患者感知心脏康复障碍与心脏康复依从性间的中介效应值为-0.126,占总效应的25.51%(-0.126/-0.494)。结论老年PCI术后患者心脏康复依从性较差。感知心脏康复障碍降低老年PCI术后患者心脏康复依从性,心脏影响否认在感知心脏康复障碍与心脏康复依从性间发挥部分中介效应。Objective To investigate the impact of perceived barriers to cardiac rehabilitation on adherence to cardiac rehabilitation and the mediating effect of cardiac impact denial in elderly patients after percutaneous coronary intervention(PCI).Methods This study was a cross-sectional survey.From August 2023 to July 2024,336 elderly patients with PCI who were discharged from the First Affiliated Hospital of Wenzhou Medical University and needed phase Ⅱ cardiac rehabilitation were selected for the study.General Information Questionnaire,Adherence of Cardiac Rehabilitation Assessment Scale in Patients with Coronary Heart Disease(ACRAS-CHD),Cardiac Rehabilitation Barriers Scale(CRBS),and Cardiac Denial of Impact Scale(CDIS)were used to survey the patients.Bootstrap method was used to sample 5000 for mediating effect tests.Results A total of 336 questionnaires were distributed and 324 valid questionnaires were recovered,with a valid recovery rate of 96.43%(324/336).Among 324 elderly patients after PCI,ACRAS-CHD score,CRBS score,and CDIS score were(73.19±5.46),(79.35±6.60),and(30.57±3.66),respectively.The direct effect of perceived barriers to cardiac rehabilitation on adherence to cardiac rehabilitation in elderly patients after PCI was-0.368,which accounted for 74.49%(-0.368/-0.494)of the total effect.The mediating effect of cardiac impact denial between perceived barriers to cardiac rehabilitation and adherence to cardiac rehabilitation in elderly patients after PCI was-0.126,which accounted for 25.51%of the total effect(-0.126/-0.494).Conclusions Elderly patients after PCI have poor adherence to cardiac rehabilitation.Perceived cardiac rehabilitation barriers reduce cardiac rehabilitation adherence in elderly patients after PCI,and cardiac impact denial exerts a partial mediating effect between perceived cardiac rehabilitation barriers and cardiac rehabilitation adherence.

关 键 词：经皮冠状动脉介入治疗 心脏康复 伴依从性 感知心脏康复障碍 心脏影响否认 

分 类 号：R541.4[医药卫生—心血管疾病]