关键词: 心力衰竭, 自我损耗, 发展轨迹, 影响因素分析, 护理

Abstract:

Objective To explore the development trajectory of ego depletion in patients with heart failure and analyze the influencing factors，aiming to provide a basis for the implementation of targeted intervention measures. Methods Convenience sampling was adopted to select heart failure patients who were hospitalized in a tertiary hospital in Nanjing from July 2024 to March 2025 as the survey subjects. The general information questionnaire，the Ego-Depletion Scale for Heart Failure Patients，the Symptom Status Questionnaire-Heart Failure，the Perceived Social Support Scale，and the Chinese version of the Distress Disclosure Index were used to collect baseline（T0） data. The Ego-Depletion Scale for Heart Failure Patients was used to assess the ego-depletion level of the patients 1 month（T1），3 months（T2），and 6 months（T3） after discharge. The latent class growth model was used to analyze the change trajectory of ego depletion in heart failure patients，and multiple Logistic regression was used to analyze the influencing factors of different trajectory categories. Results A total of 338 patients were included. During the T1 to T3 periods，20，17，and 14 patients were lost to follow-up respectively. Eventually，a total of 287 patients were included. The ego depletion scores of heart failure patients at the 4 time points were 52.00（42.00，61.00），43.00 （34.00，53.00），40.00（34.00，54.00），39.00（33.00，51.00） points. The 3 subgroups of ego depletion change trajectories were identified： moderate depletion-slow adaptation type（63.07%），moderate depletion-rebound increase type （24.04%），and high depletion-fluctuating improvement type（12.89%）. The results of Logistic regression analysis showed that the number of comorbidities，the level of fatigue or lack of energy and perceived social support were the influencing factors of the ego depletion change trajectory of heart failure patients（all P<0.05）. Conclusion The ego depletion of patients with heart failure shows a gradually decreasing trend in the short term after discharge，but there is a population heterogeneity development trajectory. Healthcare professionals should formulate precise nursing interventions based on the characteristics of these trajectories and the influencing factors，in order to improve the ego depletion level of heart failure patients and enhance their self-management ability.

Key words: Heart Failure, Ego Depletion, Development Trajectory, Analysis of Influence Factors, Nursing Care