心房颤动患者射频消融术后运动恐惧的潜在剖面分析

Kinesiophobia in atrial fibrillation patients after radiofrequency catheter ablation:a latent profile analysis

目的探究心房颤动(房颤)患者射频消融术后运动恐惧的特征差异,以期为临床开展精准干预提供参考。方法选取上海市4所三级医院心内科门诊随访的475例房颤术后患者作为研究对象,采用一般资料调查表、心脏病患者运动恐惧量表、领悟社会支持量表进行调查。采用潜在剖面分析识别房颤患者射频消融术后运动恐惧特征的类别,采用有序多分类logistic回归进一步分析影响因素。结果潜在剖面分析研究结果显示,房颤患者射频消融术后运动恐惧可分为低水平运动恐惧组(29.05%)、中等水平运动恐惧组(48.21%)和高水平运动恐惧组(22.74%)。三组年龄、文化程度、职业状态、居住方式、房颤病程、症状分级、领悟社会支持得分比较,差异有统计学意义(均P<0.05)。有序多分类logistic回归分析结果显示,文化程度为小学及以下和房颤症状分级是患者运动恐惧的危险性因素;房颤病程<3年和领悟社会支持是患者运动恐惧的保护性因素(均P<0.05)。结论房颤患者射频消融术后运动恐惧水平存在显著异质性,医护人员可依据不同人群特征给予针对性干预策略,以降低其术后运动恐惧水平。

Objective To identify the latent class of kinesiophobia characteristics in atrial fibrillation(AF)patients after radiofrequency catheter ablation(RFCA),in order to provide reference for clinical accurate intervention.Methods 475 post-RFCA patients who were followed up in the cardiology outpatient department of four tertiary hospitals in Shanghai were selected as the study subjects.They were investigated by general information questionnaire,Tampa Scale for Kinesiophobia Heart(TSK-SV Heart)and Perceived Social Support Scale(PSSS).Latent profile analysis(LPA)was used to explore the latent class of kinesiophobia,and ordinal logistic regression analysis was used to compare the characteristics of each latent class.Results The results of LPA showed that there were significant individual differences in kinesiophobia in post-RFCA patients,which could be divided into three latent profiles,the rate of low level kinesiophobia group was 29.05%,the rate of moderate level kinesiophobia group was 48.21%and the rate of high level kinesiophobia group was 22.74%.Three groups showed statistically significant differences in age,education level,occupational status,residential form,AF duration,symptom classification,and PSSS score(P<0.05 for all).Ordinal logistic regression analyses showed that elementary school and belowand symptom classification were risk factors for kinesiophobia,whereas AF duration<3 years and PSSS scorewere protective factors for kinesiophobia(P<0.05 for all).Conclusions There is significant heterogeneity in the level of kinesiophobia in AF patients after RFCA.Medical staff should carry out targeted intervention strategies to reduce the level of kinesiophobia according to the characteristics of different populations.