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

摘要：

目的 探索慢性心力衰竭患者习得性无助现状并分析其影响因素。 方法 采用混合研究方法中的聚敛式混合设计，便利选取2025年1—10月在南通市某三级甲等医院心血管内科住院的380例慢性心力衰竭患者为调查对象，量性研究使用一般资料调查表、习得性无助量表、中文版心衰特异性健康素养量表、简易疾病感知问卷、领悟社会支持量表和医学应对方式量表进行调查，采用多元线性回归探究其影响因素；质性研究选取同期量性研究中16例慢性心力衰竭患者进行半结构式访谈，使用传统内容分析法对资料进行分析。采用联合展示法对研究结果进行综合分析。 结果 共回收有效问卷362份。慢性心力衰竭患者习得性无助得分为（47.12±8.66）分。量性研究结果显示，工作情况（务农）、心功能分级、近1年住院次数、健康素养、领悟社会支持和应对方式是其习得性无助的影响因素（P<0.05）。质性研究共提炼出3个主题：习得性无助的表征、习得性无助的危险因素、习得性无助的缓解因素。整合结果显示，量性研究与质性研究中“心功能分级与近1年住院次数”“应对方式”和“社会支持”表现为一致，“经济负担重”“认知上的无望与归因偏差”“生命意义找寻”和“健康素养”表现为补充。 结论 慢性心力衰竭患者习得性无助处于中等水平，受个人和社会等方面的影响，医护人员应及时评估，提供针对性的心理干预，引导患者积极应对疾病，同时构建多维支持网络，以降低患者习得性无助。

关键词: 心力衰竭, 习得性无助, 混合研究, 护理