急性冠脉综合征患者心脏康复后职业恢复影响因素分析

Influencing Factors of Occupational Recovery in Patients with Acute Coronary Syndrome after Cardiac Rehabilitation

目的:探讨急性冠脉综合征患者心脏康复后职业恢复影响因素,以期为心脏康复护理工作提供更多依据和方向。方法:选择2019年1月-2020年1月本院收治的80例急性冠脉综合征患者为研究对象。于患者入院时记录患者一般情况,包括年龄、性别、受教育程度、婚姻状况、职业性质、月收入、医保类型、入院诊断、合并症。于出院时评估记录患者遇事应对态度、社会支持度、心脏相关焦虑症状、幸福感指数、改变生活方式的动机、健康预后自我评价、压力情况。出院后随访1年,了解患者职业恢复情况。分析急性冠脉综合征患者心脏康复后职业恢复的影响因素。结果:出院1年后,48例(60.00%)患者回到工作岗位,其中27例(56.25%)回到原工作岗位,21例(43.75%)工作变动;32例未回到工作岗位的患者中,18例(56.25%)办理退休,其余14例(43.75%)仍处于失业状态。单因素分析显示,男性、年龄≤45岁、脑力劳动、合并症<3种、遇事应对消极<12分、社会支持度≥40分、心脏焦虑症状<36分及健康预后自我评价良好患者职业恢复率更高(P<0.05)。多因素logistic回归分析显示,年龄、性别、职业性质、合并症、消极、社会支持度、心脏焦虑症状及健康预后自我评价均为ACS患者职业恢复的独立影响因素(P<0.05)。结论:在对ACS适职患者心脏康复护理过程中应在原基础上加入社会心理支持改善措施,尤其对于年龄偏大、女性、体力劳动及合并症较多的患者,以帮助其恢复职业。

Objective:To explore the influencing factors of occupational recovery in patients with acute coronary syndrome after cardiac rehabilitation in order to provide more basis and direction for cardiac rehabilitation nursing work.Method:A total of 80 patients with acute coronary syndrome admitted to our hospital from January 2019 to January 2020 were selected as the study subjects.The general information of the patients was recorded at the time of admission,including age,sex,education,marital status,occupation,monthly income,type of medical insurance,admission diagnosis,and complications.Upon discharge,the patients’ coping attitude,social support,heart-related anxiety symptoms,happiness index,motivation to change lifestyle,self-evaluation of health prognosis,and stress were assessed and recorded.The patients were followed up for 1 year after discharge to understand the occupational recovery of patients.The influencing factors of occupational recovery of patients with acute coronary syndrome after cardiac rehabilitation were analyzed.Result:1 year after discharge,48 (60.00%) patients returned to work,of which 27 (56.25%) patients returned to the original work,21 (43.75%) patients job change;among the 32 patients who did not return to work,18 (56.25%) patients dealt with retirement,and the remaining 14 (43.75%) patients were still unemployed.Univariate analysis showed that men,age ≤45 years old,mental work,complications <3,negative coping <12 points,social support ≥40 points,heart anxiety symptoms <36 point and self-evaluation of good health prognosis had higher occupational recovery rate (P<0.05).Multivariate logistic regression analysis showed that age,gender,occupational nature,complications,negative,social support,heart anxiety symptoms and self-evaluation of health prognosis were independent factors of occupational recovery in ACS patients (P<0.05).Conclusion:In the nursing process of cardiac rehabilitation for the ACS patients,improvement measures of psychosocial support should be added on the original basis,especially for the elderly,female,physical labor and patients with more complications,so as to help them resume their careers.