Abstract:

Objective To explore the characteristics of latent profiles of ego depletion in patients with heart failure，and analyze the impacts of these profiles on patients’ self-management behavior. Methods 280 heart failure patients who were hospitalized in a tertiary grade A hospital were conveniently selected in Nanjing from April to October 2024 as study subjects. The investigation utilized a general information questionnaire，the Ego-Depletion Scale for Heart Failure Patients，the Self-Management Scale of Heart Failure Patients，and the Chronic Disease Self-Efficacy Scale. The latent profile categories of ego depletion was explored in heart failure patients. Univariate analysis and multiple Logistic regression analysis were used to investigate the influencing factors of different latent profile categories and the impact of each category on patients’ self-management levels. Results The ego depletion of 255 heart failure patients could be classified into 3 latent profiles：self-adaptive low depletion group（35.29%），symptom distressed moderate depletion group（43.53%），and social life change high depletion group（21.18%）. Multiple Logistic regression analysis showed that residence，primary caregiver，education level，New York Heart Association cardiac function grade，and self-efficacy score were factors influencing the potential profile of ego depletion in heart failure patients（P<0.05）. The comparison of self-management scores among patients in different latent profiles of ego depletion showed statistically significant differences（P<0.05）. Conclusion The level of ego depletion in patients with heart failure is high with significant heterogeneity. Medical staff should pay attention to the heterogeneity and influencing factors of ego depletion in patients with heart failure in time，and develop personalized comprehensive intervention strategies to alleviate ego depletion and improve their self-management levels.

Key words: Heart Failure, Ego Depletion, Latent Profile Analysis, Self-Management Behavior, Root Cause Analysis, Nursing Care

摘要：

目的 探究心力衰竭患者自我损耗潜在类别特征，分析不同潜在类别对患者自我管理行为的影响。方法 便利选取2024年4—10月在南京市某三级甲等综合医院住院的心力衰竭患者280例作为调查对象，采用一般资料调查表、心力衰竭患者自我损耗量表、心力衰竭患者自我管理量表及慢性疾病自我效能感量表进行调查。探索心力衰竭患者自我损耗的潜在剖面类别，并通过单因素分析、多元Logistic回归分析等探讨不同潜在剖面的影响因素及各类别对患者自我管理水平的影响。结果 255例心力衰竭患者自我损耗可分为3个潜在剖面，包括自适应低损耗组（35.29%）、症状困扰中损耗组（43.53%）、社会生活改变高损耗组（21.18%）。多元Logistic回归分析结果显示，居住地、主要照顾者、文化程度、心功能分级及自我效能得分是心力衰竭患者自我损耗潜在剖面分类的影响因素（P<0.05）。不同自我损耗潜在剖面类别的患者自我管理得分比较，差异有统计学意义（P<0.05）。结论 心力衰竭患者的自我损耗水平较高且具有明显的异质性，医护人员应及时关注患者自我损耗异质性特征及其影响因素，制订个性化的干预策略，以缓解患者的自我损耗，提高其自我管理能力。

关键词: 心力衰竭, 自我损耗, 潜在剖面分析, 自我管理行为, 影响因素分析, 护理