心血管疾病发病风险感知与客观估算风险的相关性及护理对策

Cardiovascular disease risk perception and overall risk:correlation and solutions

目的探讨心血管疾病(cardiovascular disease,CVD)发病风险感知与总体风险的关系,为制订针对性干预对策提供依据。方法2022年3月—7月便利选取杭州市某三级甲等医院的体检人群和来院就诊的糖尿病、高血压患者735例作为调查对象,采用一般资料调查表、CVD总体风险评估工具和CVD风险感知评估工具进行调查,分析不同人口学特征人群CVD绝对风险感知与总体风险值的相关性,比较绝对风险感知与总体风险值的差异。结果共回收有效问卷692份,有效问卷回收率为94.1%。CVD总体风险值为1.0%(0.2%,6.4%),绝对风险感知为2.0(1.0,3.0)。CVD绝对风险感知与总体风险值呈正相关(r_(s)=0.181,P<0.001)。分层分析显示,40~59岁、低体重或肥胖、少数民族、小学及以下文化程度、单身、吸烟、饮酒、有无糖尿病现病史、有无服用降糖药、有高血压现病史、服用降压药、高胆固醇血症人群中,绝对风险感知与总体风险值无显著相关性(P>0.05)。绝对风险感知分级与总体风险分级比较,差异具有统计学意义(χ^(2)=16.17,P=0.003),风险感知低估率、一致率、高估率分别为30.3%、56.5%、13.2%。结论风险感知低估普遍存在,医护人员应重点关注风险感知与总体风险不一致的人群,并针对个体风险特征制订针对性的干预策略,以改善其风险感知、降低CVD的发生风险。

Objective To explore the relationship between cardiovascular disease(CVD)risk perception and overall risk,and to provide evidence for formulating targeted intervention strategies.Methods A total of 735 participants including physical examination subjects and patients with diabetes or hypertension from a tertiary Grade A hospital in Hangzhou were recruited from March to July 2022.The general information questionnaire,CVD overall risk assessment model and risk perception assessment tool were used to investigate the correlation between the absolute risk perception and the overall risk value of different demographic characteristics,and to compare the difference between the absolute risk perception and the overall risk.Results A total of 692 valid questionnaires were collected with a recovery rate of 94.1%.The median(P25,P75)of CVD overall risk was 1.0%(0.2%,6.4%),and the median(P25,P75)of absolute risk perception was 2.0(1.0,3.0).The absolute risk perception of CVD was positively correlated with the total risk value(r_(s)=0.181,P<0.001);stratified analysis showed that there was no significant correlation between risk perception and objective CVD risk among people aged 40~59,with low weight or obesity,ethnic minorities,education level of primary school or below,single,smokers,drinkers,diabetes or not,taking anti-diabetic or not,hypertension,blood pressure medications,and hypercholesterolemia(P>0.05).There was a significant difference between the absolute risk perception classification and the overall risk classification(χ^(2)=16.17,P=0.003).The risk underestimation,accurate perception and overestimation rates were 30.3%,56.5%and 13.2%,respectively.Conclusion CVD risk underestimation is common.Medical staff should focus on the characteristic population whose risk perception is inconsistent with the overall risk,and formulate targeted intervention strategies to improve their risk perception and reduce the risk of CVD.