急性心肌梗死经PCI治疗患者出院后自我护理能力的影响因素

Influencing factors of self-care ability after discharge of patients with acute myocardial infarction after PCI

目的观察急性心肌梗死(AMI)患者经皮冠状动脉介入术(PCI)治疗出院后的自我护理能力状况,并分析患者出院后自我护理能力的影响因素。方法选取2018年6月至2020年6月江苏省徐州市肿瘤医院收治的200例符合PCI治疗条件并接受PCI治疗的患者,出院后随访3个月,随访结束时,根据患者的自我护理能力测定量表评分将其分为低水平组(≤57分,81例)和中高水平组(≥58分,119例)。采用一般资料调查问卷记录两组基线资料并比较,采用一般自我效能感量表(GSES)评价其自我效能感。采用多因素分析AMI经PCI治疗患者出院后自我护理能力的影响因素。结果200例患者经评估,自我护理能力低水平81例(40.50%),中等水平65例(32.50%),高水平54例(27.00%)。低水平组有负性情绪占比、用药种类1~2种占比均高于中高水平组,差异有统计学意义(P<0.05)。两组文化水平、GSES评分比较,差异有统计学意义(P<0.05)。多因素分析显示,低文化水平、有负性情绪、用药种类1~2种是经PCI治疗AMI患者自我护理能力低下独立危险因素(均OR>1,P<0.05),高GSES评分是其保护因素(OR<1,P<0.05)。结论经PCI治疗的AMI患者出院后自我护理能力水平低下,可能受到患者自身文化水平低下、负性情绪、用药种类少及自我效能感低下等因素影响,临床应重点关注上述因素,给予针对性干预措施。

Objective To observe the self-care ability after discharge of patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI),and to analyze the influencing factors of self-care ability after discharge of patients.Methods A total of 200 patients who met the treatment criteria for PCI and received PCI were selected from Xuzhou Cancer Hospital,Jiangsu Province from June 2018 to June 2020.After discharge,the patients were followed up for three months.At the end of follow-up,the patients were divided into low level group(≤57 points,81 cases)and medium high level group(≥58 points,119 cases)according to their exercise of self-care agency scale scores.A general data questionnaire was used to record the baseline data of patients and were compared.The general self-efficacy scale(GSES)was used to evaluate their self-efficacy.Multivariate analysis was used to analyze the factors affecting the self-care ability of patients with AMI treated by PCI after discharge.Results Among the 200 patients,81 cases(40.50%)had low self-care ability,65 cases(32.50%)had moderate self-care ability,and 54 cases(27.00%)had high self-care ability.The proportion of negative emotions and one to two kinds of medication in the low level group were higher than those in the middle and high level group,and the difference was statistically significant(P<0.05).There were statistically significant differences in educational level and GSES scores between the two groups(P<0.05).Multivariate analysis showed that low education level,negative emotion and one or two kinds of medication were independent risk factors for low self-care ability of AMI patients treated with PCI(all OR>1,P<0.05),and high GSES score was the protective factor(OR<1,P<0.05).Conclusion The level of self-care ability of AMI patients with the treatment of PCI is low after discharge,which may be affected by the factors such as low educational level,negative emotion,less types of medication and low self-efficacy,clinical should focus on the above factors to give targeted intervention measures.