中青年急性心肌梗死患者早期康复阶段恐惧疾病进展分型及影响因素分析

doi:10.3761/j.issn.0254-1769.2023.04.003

摘要/Abstract

摘要：

目的分析院外早期康复阶段中青年急性心肌梗死（acute myocardial infarction，AMI）患者恐惧疾病进展的现况及其潜在剖面类别，并探讨不同类别的影响因素。方法采用便利抽样法，选取2021年1月—2022年8月在广州市某所三级甲等医院住院治疗的中青年AMI患者作为调查对象，采用一般资料调查表、中文版恐惧疾病进展简化量表、中文版压力知觉量表和社会支持评定量表在患者出院后1个月进行调查。对中青年AMI患者恐惧疾病进展进行潜在剖面分析，并通过单因素分析和多元Logistic回归探讨其影响因素。结果共纳入调查对象352例，其中文版恐惧疾病进展简化量表得分为44（28，51）分。中青年AMI患者恐惧疾病进展可分为“恐惧低风险型”（23.86%）、“恐惧高风险型”（20.46%）、“严重恐惧型”（55.68%）3个潜在剖面类别，其影响因素包括紧张感、失控感、客观支持、社会支持利用度、慢性合并症情况（均P<0.05）。结论中青年AMI患者院外早期康复阶段的恐惧疾病进展水平偏高，且存在异质性。护士应重点关注恐惧高风险型及严重恐惧型患者，并根据不同类别的特征及影响因素，尽早对AMI患者的恐惧疾病进展采取针对性预防及心理护理。

关键词: 急性心肌梗死, 恐惧疾病进展, 中青年, 心脏康复, 潜在剖面分析, 影响因素分析, 护理

Abstract:

Objective To analyze the situation and latent profiles of fear of progression in young and middle-aged acute myocardial infarction（AMI） patients in the out-hospital early rehabilitation stage，and to explore the influencing factors of different profiles. Methods Through convenience sampling，young and middle-aged AMI patients who were hospitalized in a tertiary hospital in Guangzhou from January 2021 to August 2022 were recruited. The investigation was processed 1 month after hospital discharge. The demographic questionnaire，the Chinese version of the Fear of Progression Questionnaire-Short Form（Fop-Q-SF） and the Perceived Stress Scale（PSS），and the Social Support Rating Scale（SSRS） were used for investigation. Latent class analysis（LCA） was used to explore the latent profiles of fear of progression in young and middle-aged AMI patients. The influencing factors of latent profiles were identified by univariate analysis and multivariate Logistic regression. Results The total score of the Chinese version of the FoP-Q-SF in 352 patients is 44（28，51）. The fear of progression in young and middle-aged AMI patients is divided into 3 latent classes，namely “low-risk fear”（23.86%），“high-risk fear”（20.46%），and “severe fear”（55.68%）. The influencing factors include perceived stress，perceived loss of control，objective social support，availability of social support，and chronic comorbidity situation（all P<0.05）. Conclusion During out-hospital early rehabilitation，the level of fear of progression in young and middle-aged AMI patients is high with heterogeneity，which could be divided into 3 latent profiles. Nurses should focus on patients with high-risk fear and severe fear and conduct early targeted prevention and mental care according to the characteristics and influencing factors of different latent profiles.

Key words: Acute Myocardial Infarction, Fear of Progression, Young and Middle-aged, Cardiac Rehabilitation, Latent Class Analysis, Root Cause Analysis, Nursing Care

苏瑾, 杨巧红, 李耀霞, 熊佳铭, 邱玮瑜. 中青年急性心肌梗死患者早期康复阶段恐惧疾病进展分型及影响因素分析[J]. 中华护理杂志, 2023, 58(4): 406-413.

SU Jin, YANG Qiaohong, LI Yaoxia, XIONG Jiaming, QIU Weiyu. Classification and influencing factors of fear of progression in young and middle-aged patients with acute myocardial infarction in early rehabilitation[J]. Chinese Journal of Nursing, 2023, 58(4): 406-413.

图/表 6

表1 调查对象一般资料在不同潜在剖面类别间的比较[例（百分比，%）]

Table 1 Classification of latent profiles of general demographic data[cases（percentages，%）]

表2 中青年急性心肌梗死患者恐惧疾病进展潜在剖面分析拟合指标

Table 2 Fit indices for latent class analysis of fear of progression in young and middle-aged AMI patients

表3 中青年急性心肌梗死患者恐惧疾病进展3个潜在剖面类别归属概率矩阵

Table 3 Three latent profiles probability matrices of fear of progression in young and middle-aged AMI patients

图1 中青年急性心肌梗死患者恐惧疾病进展的3个潜在剖面类别

Figure 1 Three latent profiles of fear of progression in young and middle-aged AMI patients

表4 调查对象汉化版恐惧疾病进展简化量表、中文版压力知觉量表、社会支持评定量表得分在不同潜在剖面类别间的比较[n=352，分，M（P25，P75）]

Table 4 Classification of latent profiles of the scores of the Fop-Q-SF and PSS， and SSRS[n=352，scores，M（P25，P75）]

表5 中青年急性心肌梗死患者恐惧疾病进展潜在剖面类别的多元Logistic回归结果

Table 5 Multivariate Logistic analysis results on influencing factors of latent profiles of fear of progression in young and middle-aged AMI patients

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