冠心病患者心脏康复参与意愿的调查分析

来源期刊：广州医药 | 723-729 发布时间：2024-08-21 收稿时间：2025/11/13 18:47:01 阅读量：45

作者：: 陶丽,

文若兰,

范婷,

龚兰娟,

赖杏,

朱燕梅,

关键词：: 冠心病心脏康复参与意愿影响因素干预措施; coronary heart disease cardiac rehabilitation willingness to participate influencing factors interventions

DOI：: 10.3969/j.issn.1000-8535.2024.07.004

收稿时间：: 2023-12-06
修订日期：
接收日期：
引用总数：: 2

目的研究影响冠状动脉粥样硬化性心脏病（冠心病）患者参与心脏康复意愿的因素及干预措施。方法选取高州市人民医院 2021年1月—2022年3月收治的624例冠心病患者为研究对象,使用自行设计的调查问卷心脏康复参与意愿调查表及西雅图心绞痛量表对患者进行调查评估,分析冠心病患者心脏康复参与意愿现状及其影响因素。结果 624例冠心病患者中,162例愿意参加（25.96%）,126例希望参加（20.19%）,66例计划参加（10.58%）;单因素分析显示影响冠心病患者心脏康复参与意愿的因素主要包括社会支持、文化水平、娱乐活动、呼吸困难及心绞痛,社会支持方面,主观支持、客观支持、支持利用度得分分别为（2.32±0.41）（2.99±0.74）（2.58±0.95）分,组间比较差异有统计学意义（F=53.428,P<0.001）;文化水平方面,初中及以下、高中及中专、大专及以上得分分别为（2.35±0.18）（2.61±0.90）（3.09±0.63）分,组间比较差异有统计学意义（F=29.947,P<0.001）;娱乐活动方面,无、偏少、正常得分分别为（2.60±0.12）（2.88±0.29）（3.13±0.72）分,组间比较差异有统计学意义（F=44.903,P<0.001）;呼吸困难方面,≥1次/天、≥1次/周、<1次/月或无得分分别为（2.09±0.84）（2.31±0.70）（3.06±0.53）分,组间比较差异有统计学意义（F=116.082,P<0.001）;心绞痛方面,≥1次/天、≥1次/周、<1次/月或无得分分别为（2.51±0.33）（2.82±0.76）（3.15±0.87）分,组间比较差异有统计学意义（F=16.442,P<0.001）;多因素分析显示影响冠心病患者心脏康复参与意愿的独立影响因素主要包括文化程度、娱乐活动、呼吸困难及社会支持,结果有统计学意义（P<0.05）。结论文化程度、娱乐活动、呼吸困难及社会支持等因素是导致冠心病患者心脏康复参与意愿较低的主要原因,临床上应对此予以重视,并采取康复教育、实施延续性护理、建立支持环境等措施,促使冠心病患者积极参与到心脏康复中,从而有效改善其预后。

Objective To study the factors and intervention measures that affect the willingness of coronary heart disease patients to participate in cardiac rehabilitation．Methods A total of 624 patients with coronary heart disease admitted to Gaozhou People's Hospital from January 2021 to March 2022 were selected as the research subjects．A self-designed survey questionnaire on willingness to participate in cardiac rehabilitation and the Seattle Angina Pectoris Scale were used to investigate and evaluate the patients．The current status and influencing factors of willingness to participate in cardiac rehabilitation in coronary heart disease patients were analyzed．Results Among 624 patients with coronary heart disease,162 were willing to participate（25.96%）,126 hoped to participate（20.19%）,and 66 planned to participate（10.58%）．Uunivariate analysis showed that the main factors affecting the willingness of coronary heart disease patients to participate in cardiac rehabilitation included social support,education level,entertainment activities,breathing difficulties,and angina．In terms of social support,subjective support,objective support,and support utilization scores were（2.32±0.41）points,（2.99±0.74）points,and（2.58±0.95）points,respectively,with statistically significant differences（F=53.428,P<0.001）．In terms of education level,the scores for middle school and below,high school and vocational school,college and above were（2.35±0.18）points,（2.61±0.90）points,and（3.09±0.63）points,respectively,with statistically significant differences（F=29.947,P<0.001）．In terms of entertainment activities,the scores for none,less and normal were（2.60±0.12）points,（2.88±0.29）points,and（3.13±0.72）points,respectively,with statistically significant differences（F=44.903,P<0.001）．In terms of breathing difficulties,the scores for ≥1 time/day,≥1 time/week,<1 time/month,or no were（2.09±0.84）points,（2.31±0.70）points,and（3.06±0.53）points,respectively,with statistical significance（F=116.082,P<0.001）．In terms of angina,the scores for ≥1 time/day,≥1 time/week,<1 time/month,or no were（2.51±0.33）points,（2.82±0.76）points,and（3.15±0.87）points,respectively,with statistical significance（F=16.442,P<0.001）．Multivariate analysis showed that the independent influencing factors on the willingness of coronary heart disease patients to participate in cardiac rehabilitation mainly include education level,entertainment activities,breathing difficulties,and social support,and the results were statistically significant（P<0.05）．Conclusions Education level,entertainment activities,breathing difficulties,and social support are the main reasons for the low willingness of coronary heart disease patients to participate in cardiac rehabilitation．Clinical attention should be paid to this and measures such as rehabilitation education,implementation of continuity of care,and establishment of a supportive environment should be taken to encourage coronary heart disease patients to actively participate in cardiac rehabilitation and effectively improve their prognosis．

1、宋文馨,严凤娇,万丽红.老年冠心病住院患者Ⅱ期心脏康复参与意愿及影响因素分析[J].护理学杂志,2023,38(8):95-97,105.

2、王琼丽,苏会钦,黄循夫等.老年冠心病患者心脏康复参与度的影响因素[J].中华老年多器官疾病杂志,2023,22(8):598-601.

3、刘凤,宋雪,任静等.冠心病住院患者心脏康复需求现状及影响因素分析[J].护士进修杂志,2021,36(16):1472-1476,1504.

4、刘霞,温弗乐,章雅青.冠心病患者参加门诊心脏康复的障碍水平调研及相关因素分析[J].上海交通大学学报(医学版),2022,42(10):1448-1457.

5、孙红. 冠状动脉旁路移植术后患者主动参与Ⅰ期心脏康复意愿和现状的调查问卷研制[J].中国药物与临床,2020,20(5):718-720.

6、胡强,韩雪松,李安娜等.冠心病心脏康复患者的关注焦点和影响因素分析[J].临床心血管病杂志,2022,38(10):817-822.

7、齐喜玲,许海燕,于子凯等.冠心病患者出院后居家心脏康复依从性分析[J].中国康复医学杂志,2021,36(1):100-102.

8、范玺,柳春霞.冠心病患者心脏康复参与意愿的影响因素及促进对策[J].国际护理学杂志,2022,41(1):20-24.

9、田云,郑艳,李菊,等.家庭心脏康复训练对冠心病患者康复疗效影响的Meta分析[J].护士进修杂志,2020,35(13):1168-1175.

10、陈莹莹,黎万汇,江莹,等.基于ICF框架的冠心病患者心脏康复护理评估类目的Rasch模型分析[J].中国护理管理,2022,22(4):613-619.

11、李莺,冯雪,陈碧云,等.Ⅱ期心脏康复对冠心病术后患者运动能力、社会支持和自我效能的影响[J].现代临床护理,2022,21(4):38-44.

12、赵孟利,黄惠桥,陶品月,等.冠心病患者康复运动知信行问卷的编制及信效度检测[J].护理学杂志,2020,35(7):87-88,109

13、瞿佳嫣,陆静波,姚蓉,等.冠心病PCI术后心脏运动康复护理知信行问卷的研制及信效度检验[J].护理研究,2021,35(9):1644-1648.

14、 ALONDERIS A,RASKAUSKIENE N,GELZINIENE V,et al.Undiagnosed sleep apnoea in cardiac rehabilitation:Age-dependent effect on diastolic function in coronary artery disease patients with preserved ejection fraction[J].Eur J Cardiovasc Nurs,2021,20(3):202-211.

15、张振英,孙兴国,席家宁,等.门诊和住院运动锻炼为核心的整体管理对慢性心力衰竭患者心脏康复治疗效果影响的临床研究[J].中国应用生理学杂志,2021,37(1):89-95.

16、张静,霍仙娜,焦傲,等.专科团队式个体化健康管理对冠心病病人健康素养、心脏康复的影响[J].安徽医药,2021,25(12):2441-2445.

17、 PAKRAD F,AHMADI F,GRACE S L,et al.Traditional vs extended hybrid cardiac rehabilitation based on the continuous care model for patients who have undergone coronary artery bypass surgery in a middle-income country:A randomized controlled trial[J].Arch Phys Med Rehabil,2021,102(11):2091-2101.e3.

18、孟佳,杜少英,王彦,等.信息-动机-行为技巧模型联合动机性访谈在社区冠心病患者心脏康复中的应用[J].中国全科医学,2021,24(31):3990-3994.

19、 KOTLOVSKIY M Y,UDUT E V,KAIROV G T,et al.Effects of simvastatin on the metabolism of fatty acids in combined secondary prevention of coronary heart disease:Dosage and gender differences between the effects[J].Cardiovasc Hematol Disord Drug Targets,2020,20(2):93-107.

20、刘红梅,冯胜红,任静,等.渐进式Ⅰ、Ⅱ期心脏康复对冠心病患者PCI治疗后运动耐量、心功能和预后的影响[J].岭南心血管病杂志,2021,27(6):640-645.

21、张华,张双,刘淑华,等.系统心脏康复护理对冠心病患者术后生活质量的影响[J].河北医药,2020,42(16):2534-2537.

22、中华医学会,中华医学会杂志社,中华医学会全科医学分会,等.稳定性冠心病基层诊疗指南(2020年)[J].中华全科医师杂志,2021,20(3):265-273.

23、潘琪妮,黄惠桥,李宏,等.冠心病患者及其主要照顾者、护士对心脏康复信息的需求调查[J].广西医学,2021,43(16):2006-2009.

24、董玉明,杨玲,董建琴,等.北京市西城区社区全科医生对稳定性冠心病社区心脏康复认知现状的调查研究[J].中国全科医学,2021,24(34):4356-4363.

25、孙李娜. 基于5A模式对急性心肌梗死PCI术后患者早期心脏康复的应用效果[J].广州医药,2023,54(8):106-109.

26、 REN Q I,ZHOU X W,HE M Y,et al.A Quantitative diagnostic method for phlegm and blood stasis syndrome in coronary heart disease using tongue,face,and pulse indexes:An exploratory pilot study[J].J Altern Complement Med,2020,26(8):729-737.

1、贺雅勰.心脏瓣膜置换术后患者Ⅰ期心脏康复参与意愿现状及影响因素分析[D].电子科技大学,2025.DOI:10.27005/d.cnki.gdzku.2025.003166.

2、邓文娟,李凤,郭静.不稳定性心绞痛患者心脏康复的障碍水平现状及影响因素分析[J].中华保健医学杂志,2025,27(06):982-986.