老年心力衰竭患者出院过渡期症状群变化及其影响因素分析

Analysis of changes and influencing factors of symptom clusters in elderly patients with heart failure during discharge transition period

目的 探讨老年心力衰竭患者出院过渡期症状群变化及其影响因素分析。方法 采用便利抽样法选取2019年9月~2022年9月济宁医学院附属医院心内科收治的老年心力衰竭患者110例。采用Memorial心力衰竭症状评估量表(MSAS-HF)对心力衰竭患者症状(生理、心理以及心力衰竭症状)进行评估。以单因素和多元逐步回归分析影响老年心力衰竭患者出院过渡期症状群变化的独立影响因素。结果 患者出院后的生理症状、心理症状、心力衰竭症状以及总分均高于出院前[(6.53±1.41)分vs.(5.84±1.39)分、(3.84±0.74)分vs.(3.16±1.02)分、(4.02±0.62)分vs.(3.11±0.97)分、(14.58±2.52)分vs.(12.06±1.95)分],差异有统计学意义(t=3.655、5.660、8.291、14.745,P<0.05)。MSAS-HF评分与性别、体质量指数(BMI)、婚姻状况、文化程度以及心功能分级无关(P> 0.05),而与年龄、病程以及合并疾病种类有关(P<0.05)。多因素分析结果提示,年龄、病程以及合并疾病种类是影响老年心力衰竭患者出院过渡期症状群变化的独立影响因素(P<0.05)。结论 老年心力衰竭患者出院后的心力衰竭症状较严重,症状群变化受多种因素影响,其中年龄、病程以及合并疾病种类是影响老年心力衰竭患者出院过渡期症状群变化的独立影响因素。

Objebtive To analyze the changes of symptom clusters and their influencing factors in elderly patients with heart failure during discharge.Methods A total of 110 elderly patients with heart failure admitted to the Department of Cardiology,Affiliated Hospital of Jining Medical College from September 2019 to September 2022 were selected as the research objects by convenient sampling method.Memorial heart failure symptom assessment scale(MSAS-HF)was used to evaluate the symptoms(physiological,psychological and heart failure symptoms)of patients with heart failure.Single factor and multiple stepwise regression analysis were used to analyze the independent influencing factors of symptom cluster changes in elderly patients with heart failure during discharge transition period.Results The physiological symptoms,psychological symptoms,heart failure symptoms and total scores of patients after discharge were higher than those before discharge,and the differences were statistically significant(P<0.05).The physiological symptoms,psychological symptoms,heart failure symptoms and total scores of patients after discharge were higher than those before discharge[(6.53±1.41)vs.(5.84±1.39),(3.84±0.74)vs.(3.16±1.02),(4.02±0.62)vs.(3.11±0.97),(14.58±2.52)vs.(12.06±1.95)],and the differences were statistically significant(t=3.655,5.660,8.291,14.745,P<0.05).The score of MSAS-HF was not correlated with sex,BMI,marital status,educational level and heart function grade(P>0.05),but correlated with age,course of disease and type of disease(P<0.05).Multivariate analysis showed that age,course of disease and type of combined disease were independent factors affecting the changes of symptom clusters in elderly patients with heart failure during discharge(P<0.05).Conclusion The symptoms of heart failure in elderly patients with heart failure after discharge are more serious,and the changes of symptom clusters are affected by many factors.Among them,age,course of disease and type of combined disease are independent factors affecting the changes of symptom clusters in elderly patients with heart failure during the transitional period after discharge.