老年慢性心衰患者生存质量影响因素及健康需求分析

Analysis of Factors Influencing Quality of Life and Health Needs of Elderly Patients with Chronic Heart Failure

目的分析老年慢性心衰患者生活质量的影响因素和健康需求。方法应用堪萨斯心肌患者生存质量表(KCCQ)及健康需求调查表对安徽医科大学附属省立医院2019年1—9月收治的190例老年慢性心衰患者开展调查。结果NYHA心功能分级Ⅰ级、Ⅱ级142例与Ⅲ级、Ⅳ级48例患者的KCCQ体力受限、症状和生活质量3项分别为(73±18)分∶(56±21)分、(63±22)分∶(48±25)分、(60±18)分∶(54±15)分(t=6.19、4.02、3.06)。64例LEVF<50%和126例≥50%患者KCCQ体力受限和生活质量分别为(63±21)分∶(75±24)分和(57±17)分∶(64±18)分(t=6.72、4.31,P<0.01)。老年慢性心衰患者体力受限的影响因素有年龄、性别、NYHA分级、LEVF以及CCI指数;心衰症状的影响因素为年龄、性别和NYHA分级;性别及收入状况对患者的社会功能有影响。超过半数患者需要基本知识教育、饮食指导、用药指导、康复指导、定期体检、建立慢性病健康档案、日常照料者、陪同就医服务、义诊、家庭签约医生、社区家庭急救呼叫系统。结论老年慢性心力衰竭患者的生活质量较差,健康需求迫切,应提供针对性医疗及社会支持,改善患者生活质量。

Objective To analyze the influencing factors and health needs of elderly patients with chronic heart failure.Methods A 190 elderly chronic heart failure patients admitted to the Provincial Hospital of Anhui Medical University from January 2019 to September 2019 were investigated using the Kansas Myocardial Patients'Quality of Life Table(KCCQ)and Health Needs Questionnaire.Results KCCQ physical limitation,symptoms,and quality of life in NYHA cardiac function grade 142,grade 142 and gradeⅢ,grade 48 patients were(73±18)points(56±21)points,(63±22)points(48±25)points,(60±18)points(54±15)points(t=6.19,4.02,3.06,P<0.01).64 patients with LEVF<50%and 126 patients with≥50%KCCQ were physically limited and had a quality of life of(63±21)points(75±24)points and(57±17)points(64±18)points(t=6.72,4.31).The factors affecting physical limitation in elderly patients with chronic heart failure include age,gender,NYHA classification,LEVF,and CCI index;the factors affecting heart failure symptoms are age,gender,and NYHA classification;gender and income status have an impact on patients'social functions.More than half of the patients need basic knowledge education,diet guidance,medication guidance,rehabilitation guidance,regular medical examinations,establishment of chronic disease health files,daily caregivers,accompanying medical services,free consultations,family contract doctors,community family emergency call system.Conclusion The elderly patients with chronic heart failure have a poor quality of life and urgent health needs.Targeted medical and social support should be provided to improve the quality of life of patients.