肺动脉高压患者经济负担影响因素分析及护理对策

doi:10.3761/j.issn.0254-1769.2023.14.010

摘要/Abstract

摘要：

目的调查肺动脉高压患者的主、客观经济负担现状，并探讨其与健康相关生活质量的相关性。方法采取便利抽样法，选取2022年2月—9月在北京市某三级甲等医院就诊的肺动脉高压患者作为调查对象。使用一般资料调查表、慢性病治疗经济毒性功能评估综合评分（Comprehensive Score for Financial Toxicity Functional Assessment of Chronic Illness Therapy，COST）和肺动脉高压特异性健康相关生活质量量表等对患者进行调查，并分析其影响因素。结果 152例肺动脉高压患者中，123例（80.9%）存在经济负担，COST为（16.22±10.19）分；多元线性逐步回归结果显示，肺动脉收缩压、6 min步行距离、社会经济地位复合指数、灾难性医疗支出和经济相关服药不依从是肺动脉高压患者经济负担的影响因素，可解释总变异的42.9%。经济负担与健康相关生活质量存在相关性（P<0.05）。结论肺动脉高压患者主、客观经济负担普遍存在，经济负担大的患者健康相关生活质量受损严重，医护人员应重视并全面筛查患者的经济负担，防止患者在疾病管理阶段因病致贫，从而减轻经济负担对患者预后的不良影响。

关键词: 肺动脉高压, 经济负担, 健康相关生活质量, 相关性, 护理

Abstract:

Objective To investigate subjective and objective financial burden and its correlation with health-related quality of life（HRQOL） among pulmonary artery hypertension（PAH） patients. Methods From February to September 2022，we conducted convenience sampling method to select PAH patients who were followed up in a tertiary hospital，using General Information Questionnaire，Comprehensive Score for Financial Toxicity Functional Assessment of Chronic Illness Therapy（COST），and PAH-specific HRQOL measurement（EmpPHasis-10）. Logistic regression model was used to analyze the independent influencing factors. Results 152 PAH patients were included，and 123（80.9%） patients experienced financial burden，and the mean score of subjective financial burden was 16.22±10.19. The multivariate linear regression analysis showed that pulmonary artery systolic pressure（PASP），6 minute walk distance（6MWD），social-economic status，catastrophic health care expenditures，and cost-related medication nonadherence（CRNA） were influencing factors of financial burden，which accounted 42.9% of the total variation. Financial burden was correlated with EmpPHasis-10（P<0.05）. Conclusion The subjective and objective financial burden of PAH patients were common，and the HRQOL of patients with high financial burden level was seriously impaired. Medical staff should pay attention to and comprehensively screen the financial burden to prevent patients from becoming poor due to disease in the stage of disease management，so as to reduce the impact of financial burden on patients’ prognosis.

Key words: Pulmonary Artery Hypertension, Financial Burden, Health-Related Quality of Life, Correlation, Nursing Care

江莹, 余旻虹, 张春燕, 康晓凤. 肺动脉高压患者经济负担影响因素分析及护理对策[J]. 中华护理杂志, 2023, 58(14): 1733-1741.

JIANG Ying, YU Minhong, ZHANG Chunyan, KANG Xiaofeng. Investigation and analysis of influencing factors related to financial burden among pulmonary artery hypertension patients[J]. Chinese Journal of Nursing, 2023, 58(14): 1733-1741.

图/表 4

表1 调查对象的一般资料及经济负担的单因素分析（n=152）

Table 1 The general information of the subjects and the results of the univariate analysis on the influencing factors of financial burden（n=152）

表2 自变量赋值

Table 2 Assignment of included variables

表3 经济负担影响因素多元线性逐步回归分析（n=152）

Table 3 Multivariable linear stepwise regression analysis of financial burden（n=152）

表4 经济负担与健康相关生活质量的相关性分析

Table 4 Correlation of financial burden and health-related quality of life

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