关键词: 心力衰竭, 习得性无助, 混合研究, 护理

Abstract:

Objective To explore the current status of learned helplessness in patients with chronic heart failure and analyze its influencing factors. Methods The convergent mixed design in the mixed research method was used to facilitate the selection of 380 patients with chronic heart failure who were hospitalized in the cardiovascular department of a tertiary hospital in Nantong City from January to October 2025. The quantitative study was conducted using through the general information questionnaire，the learned helplessness scale，the Chinese version of the heart failure-specific health literacy scale，the simple disease perception questionnaire，the perceived social support scale，and the medical coping style scale for investigation. Multiple linear regression was used to explore its influencing factors. In the qualitative study，16 patients with chronic heart failure in the quantitative study of the same period were selected for semi-structured interviews，and the data were analyzed by traditional content analysis. The joint display method was used to comprehensively analyze the research results. Results A total of 362 valid questionnaires were collected. The score of learned helplessness in patients with chronic heart failure was（47.12±8.66） points. The results of quantitative research showed that working conditions（farming），cardiac function classification，number of hospitalizations in the past year，health literacy，perceived social support and coping style were the influencing factors of learned helplessness（P<0.05）. There were 3 themes being extracted from the qualitative research： the representation of learned helplessness，the risk factors of learned helplessness，and the mitigation factors of learned helplessness. The results of integration showed that in quantitative research and qualitative research，“cardiac function classification and the number of hospitalizations in the past year”，“coping style” and “social support” demonstrated consistency，while “heavy economic burden”，“cognitive hopelessness and attribution bias”，“search for meaning in life” and “health literacy” were supplemented. Conclusion The learned helplessness of patients with chronic heart failure is at a medium level. Affected by personal and social aspects，medical staff should evaluate in time，provide targeted psychological interventions，guide patients to actively respond to the disease，and build a multi-dimensional support network to reduce patients’ learned helplessness.

Key words: Heart Failure, Learned Helplessness, Mixed-Methods Study, Nursing Care