社区心力衰竭患者自我管理及应对方式研究

Self-management and coping styles of patients with chronic heart failure in community

目的了解社区心力衰竭患者疾病自我管理现状,评价其与应对方式之间的关系。方法以社区来源自行就医的慢性心力衰竭(CHF)患者为研究对象,共132例。采用心力衰竭患者自我管理量表进行自我管理情况评价,采用医学应对问卷(medical copingmodes questionnaire,MCMQ)评价患者CHF疾病及症状应对情况。结果CHF患者自我管理评分平均得分为(46.3±12.5)分,得分率57.9%;医学应对评价结果显示面对、回避、屈服平均得分分别为(18.4±4.2)分(得分率57.5%)、(14.2±3.5)分(得分率50.7%)与(12.4±4.1)分(得分率62.0%)。自我管理行为评分与应对方式中面对维度得分呈正相关,与回避、屈服维度评分呈负相关,相关系数差异有统计学意义(P<0.05)。多元线性回归分析结果显示,年龄、自理能力、心功能分级、应对方式中面对、回避是自我管理水平的独立影响因素。结论CHF患者自我管理水平相对较低,应提高对患者的针对性干预与心理支持,改善患者应对方式,提高患者自我管理水平。

Objective To investigate the current situation of self-management of disease in patients with chronic heart failure(CHF)in community,and to evaluate its correlation with coping styles.Methods A total of 132 patients with CHF who sought medical treatment from community were enrolled in the study.The self-management status of patients was evaluated by self-management scale,and the patient’s symptoms and coping styles were evaluated by means of medical copingmodes questionnaire(MCMQ).Results The average scores of self-management scale were 46.3±12.5,and the score rate was 57.9%.The results of MCMQ evaluation showed that the average scores of facing dimension,avoidance and yield were 18.4±4.2(score rate 57.5%)and 14.2±3.5(score rate 50.7%)and 12.4±4.1(score rate 62.0%),respectively.The self-management scores were positively correlated with facing dimension scores,however,which were negatively correlated with avoidance and yield dimension scores,and the correlation coefficient was statistically significant(P<0.05).Multiple linear regression analysis showed that patient’s age,self-care ability,cardiac function grading,coping style,and avoidance were independent influencing factors for self-management.Conclusion The self-management levels of patients with CHF are relatively lower.Targeted intervention and psychological support should be given to patients to improve the coping style of patients,so as to improve the self-management level of patients.