老年慢性心衰患者自我护理效果及影响因素分析

Effect of Self-care and Influencing Factors of Senile Patients with Chronic Heart Failure

目的探讨老年慢性心力衰竭患者自我护理效果的影响因素。方法选取2013年2月至2015年9月于我院心血管内科就诊的老年慢性心力衰竭患者280例,采用心力衰竭自我护理指数量表(SCHFI)评定患者自我护理情况,依据评分将其分为良好组(≥70分)41例和非良好组(<70分)239例,比较两组患者自我护理知识、社会支持、焦虑、抑郁评分情况,并进行自我护理效果影响因素分析。结果良好组与非良好组患者在文化程度、病程存在统计学差异(Z=-2.279,-2.050;p=0.023,0.040);良好组患者自我护理知识评分、社会支持评分均明显高于非良好组(t=7.762,8.102;p<0.001),焦虑、抑郁评分明显低于非良好组(t=-9.925,-10.794;p<0.001);Logstic回归分析结果显示,患者自我护理知识、焦虑、抑郁、病程为老年慢性心力衰竭患者自我护理的危险因素。结论自我护理知识、焦虑、抑郁、病程是影响老年慢性心力衰竭患者自我护理效果的危险因素,应强化其自我护理知识,改善其负面情绪。

Objective To explore the influencing factors of self-care effect in elderly patients with chronic heart failure. Method A total of 280 elderly patients with chronic heart failure admitted to Department of Cardiology from February 2013 to September 2015 were selected as the subjects. Heart Failure Self-Care Indicator scale（SCHFI） was adopted to evaluate self-care in the patients. According to the scores of SCHFI, the patients were divided into good group（ ≥70, n=41）, and the non-good group（〈70, n=239）. The scores of self-care knowledge, social support, anxiety and depression of the two groups were compared. The analysis of influencing factors of self-care was conducted. Results There were significant differences in the educational level and course of disease between the good group and the non-good group（Z=-2.799,-2.050; p=0.023, 0.040）. The good group yielded significantly higher scores of self-care knowledge score and social support（t=7.762, 8.102; p〈0.001）, and lower score of anxiety and depression（t=-9.925,-10.794; p〈0.001） than the control group. Logistic regression analysis showed that the self-care knowledge, anxiety, depression and course of disease were the risk factors for self-care effect in elderly patients with chronic heart failure. Conclusion Self-care knowledge, anxiety, depression, and course of disease are risk factors of self-care effect in elderly patients with chronic heart failure. The awareness of self-care should be strengthened and the negative emotions should be addressed for the elderly patients with chronic heart failure.