青海省高原地区慢性心力衰竭患者健康生活方式对再住院的影响及护理对策

doi:10.3761/j.issn.0254-1769.2023.19.010

摘要/Abstract

摘要：

目的探讨青海省高原地区慢性心力衰竭（chronic heart failure，CHF）患者健康生活方式对再住院的影响，并提出针对性的护理干预策略。方法便利选取2019年12月—2021年10月在青海省4所三级甲等医院收治的CHF患者1 280例作为调查对象，采用自制的CHF患者健康生活方式问卷进行调查。该问卷包括患者一般资料调查表和健康生活方式调查表，健康生活方式调查表包括戒烟限酒、规律运动、合理膳食、压力管理（焦虑、抑郁）、体重指数、睡眠、社会支持等7个维度，其中焦虑、抑郁采用综合医院焦虑/抑郁情绪量表（Hospital Anxiety and Depression Scale，HAD）评定、社会支持采用社会支持（Medical Outcomes Study Social Support Survey，MOS-SSS）量表评定，根据6个月内再住院情况，分为再住院组和非再住院组，分析不同健康生活方式对再住院的影响。结果剔除无效问卷107份，失访77例，最终纳入CHF患者1 096例，其中6个月内再住院599例。再住院组患者的一般资料与非再住院组比较，差异无统计学意义（P>0.05）；单因素及多因素Logistic回归分析显示，吸烟（OR=2.362）、喝酒（OR=1.866）、不规律运动（OR=1.599）、睡眠质量不佳（OR=1.481）、膳食不合理（OR=0.476）、焦虑（OR=1.158）、抑郁（OR=0.955）、社会支持度低（OR=0.965）均可增加再住院风险。结论青海省高原地区CHF患者生活方式不理想，保持健康的生活方式可降低CHF患者再住院风险，医护人员应重点关注生活方式不健康的人群，并针对个体生活方式特征制订针对性的干预策略，以改善再住院率，降低医疗成本。

关键词: 心力衰竭, 再住院, 生活方式, 高原地区, 护理干预

Abstract:

Objective To explore the influence of healthy lifestyle on the risk of re-hospitalization in patients with chronic heart failure（CHF） at high altitude in Qinghai Province and provide scientific evidence for formulating targeted intervention countermeasures. Methods A total of 1 280 patients with CHF from December，2019 to October，2021 were enrolled in 4 tertiary hospitals in Qinghai Province. General data questionnaire and self-made healthy lifestyle questionnaire were used. The healthy lifestyle questionnaire contains 7 dimensions，including non-smoking and alcohol control，regular exercise，reasonable diet，anxiety-depression，healthy body mass index（BMI），good sleep，social support. Among which the anxiety and depression dimensions were measured by the Hospital Anxiety and Depression Scale（HAD），and social support was evaluated using the Medical Outcomes Study Social Support Survey（MOS-SSS）. The effects of different healthy lifestyles on the risk of re-hospitalization according to the re-hospitalization outcomes within 6 months were analyzed in the re-hospitalization group and non-re-hospitalization group. Results 107 invalid questionnaires were removed and there were 77 lost follow-up cases；1096 patients with CHF were finally included in the study，of which 599 patients were re-hospitalized within 6 months. There was no significant difference in the general data between the re-hospitalization group and the non-re-hospitalization group （all P>0.05）. Univariate and multivariate Logistic regression analysis showed that some variations would increase risks of re-hospitalization，and they were listed by OR rankly as smoke（OR=2.362），alcohol（OR=1.866），irregular exercise（OR=1.599），poor sleep quality（OR=1.481），improper diet（OR=0.476），anxiety（OR=1.158），depression（OR=0.955），low social support（OR=0.965）. Conclusion The lifestyle of CHF patients in the plateau area of Qinghai Province is not ideal，and maintaining a healthy lifestyle can reduce the risk of re-hospitalization in CHF patients. Medical staff should focus on the population with unhealthy lifestyle，and formulate targeted intervention strategies according to individual lifestyle characteristics，so as to improve the re-hospitalization rate and reduce medical costs.

Key words: Heart Failure, Patient Re-Hospitalization, Life Style, Plateau Area, Nursing Intervention

马晓婷, 王冕, 徐文炳, 陕海云, 马爱玲, 马晓晶, 范琳琳, 樊景春, 许瑞. 青海省高原地区慢性心力衰竭患者健康生活方式对再住院的影响及护理对策[J]. 中华护理杂志, 2023, 58(19): 2373-2379.

MA Xiaoting, WANG Mian, XU Wenbing, SHAN Haiyun, MA Ailing, MA Xiaojing, FAN Linlin, FAN Jingchun, XU Rui. The influence of healthy lifestyle on the risk of re-hospitalization in patients with chronic heart failure in Qinghai-Tibet Plateau[J]. Chinese Journal of Nursing, 2023, 58(19): 2373-2379.

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