老年慢性心力衰竭患者运动恐惧现状及影响因素分析

doi:10.3761/j.issn.0254-1769.2022.04.004

摘要/Abstract

摘要：

目的调查老年慢性心力衰竭患者运动恐惧现状及影响因素。方法采用便利抽样法,选取2020年10月—2021年7月在扬州市某三级甲等医院心内科住院的老年慢性心力衰竭患者260例,以应激作用过程理论为框架,使用一般资料调查表、中文版心脏病运动恐惧量表、心力衰竭症状状态问卷、运动自我效能量表、社会支持评定量表和医学应对方式问卷进行调查,采用单因素分析及二元Logistic回归分析影响因素。结果 260例老年慢性心力衰竭患者中,运动恐惧发生率为65%。Logistic回归分析显示,学历（OR=3.369,95%CI：1.249~9.091）、心力衰竭病程（OR=2.908,95%CI：1.303~6.487）、心力衰竭症状状态问卷总分（OR=1.083,95%CI：1.036~1.132）、运动自我效能量表得分（OR=0.425,95%CI：0.234~0.772）、医学应对方式问卷的面对维度得分（OR=0.878,95%CI：0.790~0.975）、医学应对方式问卷的回避维度得分（OR=1.222,95%CI：1.062~1.406）、屈服维度得分（OR=1.327,95%CI：1.095~1.608）是老年慢性心力衰竭患者运动恐惧的影响因素。结论老年慢性心力衰竭患者运动恐惧发生率较高,学历、病程、心力衰竭症状、运动自我效能及应对方式是其影响因素,其中学历对老年慢性心力衰竭患者的影响最大。临床护理人员可重点关注学历偏低、病程较长的老年慢性心力衰竭患者,还可根据相关影响因素制订干预措施来促进老年慢性心力衰竭患者参与体力活动及身体锻炼,提高其运动耐力。

关键词: 老年人, 慢性心力衰竭, 运动恐惧, 影响因素, 护理

Abstract:

Objective To investigate the status and influencing factors of kinesiophobia in elderly patients with chronic heart failure （CHF） . Methods A total of 260 elderly CHF inpatients were recruited from the Department of Cardiology,Affiliated Hospital of Yangzhou University from October 2020 to July 2021. General data questionnaire,Chinese version of the Tampa Scale for Kinesiophobia Heart,Symptom Status Questionnaire-Heart Failure,Self-Efficacy for Exercise,Social Support Rating Scale and Medical Coping Modes Questionnaire were used for investigation. Univariate analysis and binary Logistic regression were performed to analyze the influencing factors. Results In 260 elderly patients with CHF,the incidence of kinesiophobia was 65%.Logistic regression analysis showed that education level of junior high school or below （OR=3.369,95%CI：1.249-9.091） ,course of disease <5 years （OR=2.908,95%CI：1.303~6.487） ,heart failure symptoms （OR=1.083,95%CI：1.036~1.132） ,exercise self-efficacy （OR=0.425,95%CI：0.234~0.772） ,coping mode （confronting）（OR=0.878,95%CI：0.790~0.975） ,coping mode （avoidance）（OR=1.222,95%CI：1.062-1.406） and coping mode （resignation）（OR=1.327,95%CI：1.095-1.608） were the influencing factors of kinesiophobia in elderly CHF patients. Conclusion Elderly patients with CHF have a high incidence of kinesiophobia,and patients’ education background,course of disease,heart failure symptoms,exercise self-efficacy and coping mode are influencing factors,among which educational background has the greatest impact.Clinical nursing staff can focus on elderly CHF patients with low educational level and a long course of disease,and can also develop intervention measures to promote them to participate in physical activities and exercise to improve their exercise endurance.

Key words: Aged, Chronic Heart Failure, Kinesiophobia, Influencing Factors, Nursing Care

秦静雯, 熊娟娟, 潘鑫, 龚开政. 老年慢性心力衰竭患者运动恐惧现状及影响因素分析[J]. 中华护理杂志, 2022, 57(4): 408-414.

QIN Jingwen, XIONG Juanjuan, PAN Xin, GONG Kaizheng. The status and influencing factors of kinesiophobia in elderly patients with chronic heart failure[J]. Chinese Journal of Nursing, 2022, 57(4): 408-414.

图/表 5

表1 老年慢性心力衰竭患者运动恐惧的单因素分析[例（百分比,%）]

Table 1 Univariate analysis of kinesiophobia in elderly patients with chronic heart failure [case（percentage,%）]

表2 老年慢性心力衰竭患者运动恐惧与各量表得分的相关性分析（分,$\bar{x}\pm s$）

Table 2 Correlation analysis between kinesiophobia and other related scales in elderly patients（score,$\bar{x}\pm s$）

表3 回归分析模型预测值与实测值拟合程度

Table 3 Fitting degree of predicted value and measured value of regression analysis model

表4 自变量的赋值方式

Table 4 The assignment method of classification variables introduced in regression equation

表5 老年慢性心力衰竭患者运动恐惧的二元Logistic回归分析

Table 5 Logistic regression analysis of kinesiophobia in elderly patients with CHF

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