PCI术后患者疾病感知水平与远期生存质量的相关性分析

Correlation analysis of illness perception and long-term quality of life among patients with coronary heart disease after percutaneous coronary intervention

目的探讨PCI术后患者疾病感知水平与远期生存质量的相关性，分析疾病感知的影响因素。方法采用便利抽样法，选取2015年5月-2017年5月河南科技大学第-附属医院心内科门诊随访的PCI术后3年以上的患者176例，采用中文版的疾病感知问卷修订版（IPQ-R）病情认知部分和冠状血运重建结局量表（CROQ）中CROQ-PTCA-Post部分进行疾病感知和远期生存质量调查。采用Pearson法分析疾病感知与远期生存质量的相关性，采用多元线性回归分析疾病感知的影响因素。结果176例PCI术后患者疾病感知总分为（117．58±23．44）分，生存质量总分为（61．89±6．80）分。Pearson相关分析显示，PCI术后患者疾病感知中疾病（急慢性）、后果、疾病周期性及情绪陈述4个维度与生存质量总分呈负相关（r值分别为-0．215、-0．205、-0．217、-0．220；P〈0．05）；个人控制性、治疗控制性及疾病-致性3个维度与生存质量总分呈正相关（，值分别为0．180、0．167、0．140；P〈0．05）。多元线性回归分析显示，性别、年龄、病程、文化程度及有心肌梗死病史是疾病感知的影响因素（P〈0．01）。结论PCI术后患者仍存在不正确的疾病感知，其将影响患者远期的生存质量。护理工作者应尤其加强女性、年龄小、病程短、文化程度低及未发生心梗的PCI术后患者相关方面的健康教育。

Objective To explore the correlation between illness perception and long-term quality of life among patients with coronary heart disease after per-cutaneous coronary intervention （PCI）, and analyze the influencing factors of illness perception. Methods Using convenience sampling method, the 176 patients with coronary heart disease after PCI for over 3 years, who were followed up from May 2015 to May 2017 in the department of cardiovascular medicine of the First Affiliated Hospital of He＇nan University of Science and Technology, were selected as research objects. The illness perception Questionnaire-Revised （IPQ-R） and the percutaneous transluminal coronary angioplasty part of Coronary Revascularization Outcome Questionnaire （CROQ-PTCA-Post） were used to investigate disease perception and long-term quality of life. The relationship between illness perception and long-term quality of life was analyzed by Pearson correlation analysis. The influencing factors for illness perception was analyzed by multiple linear regression analysis. Results The total score of illness perception and quality of life in the 176 patients after PCI was （117.58 ± 23.44） and （61.89 ± 6.80） respectively. The result of Pearson analysis showed that the four dimensions of disease perception （acute and chronic）, consequence, disease cycle and emotional complaint were negatively correlated with the total score of quality of life in patients after PCI （r=-0.215, -0.205, -0.217, -0.220; P 〈 0.05）. The three dimensions of self-control, treatment control and illness coherence were positively correlated with the total score of quality of life （r=0.180, 0.167, 0.140; P 〈 0.05）. Multivariate linear regression analysis showed that gender, age, course of disease, educational level and history of myocardial infarction were the influencing factors of disease perception （P 〈 0.01）. Conclusions Patients with PCI still have incorrect perception of disease, which willaffect the long-term quality of life. Nursing staff should strengthen health education especially for women, young age, short course of disease, low education level and patients without myocardial infarction after PCI.