老年慢性心力衰竭患者健康促进行为调查及其与疾病认知和不良心血管事件的关系

A survey of health promotion behavior and its relationship with disease cognition and adverse cardiovascular events in elderly patients with chronic heart failure

目的调查老年慢性心力衰竭患者健康促进行为变化,并探讨其与疾病认知、不良心血管事件的关系,为指导患者健康促进行为提供依据。方法选择2018年6月—2023年6月首都医科大学附属北京康复医院心脏康复中心收治的老年慢性心力衰竭患者为调查对象,应用一般情况调查表、健康促进生活方式量表(HPLP-C)、亚特兰大心力衰竭知识问卷(AHFKT)、简易应对方式问卷(SCSQ)对患者的基本情况、健康促进行为、疾病认知及应对方式进行评估,采用多因素Logistic回归分析健康促进行为与疾病认知的关系,同时对患者进行6个月随访,统计并分析不良心血管事件的发生情况。结果共纳入803例老年慢性心力衰竭患者,其中健康促进行为达健康水平有289例,占比35.99%;而未达健康水平有514例,占比64.01%。多因素Logistic结果显示,文化程度(OR=8.637)、家庭人均月收入(OR=5.414)、居住方式(OR=3.827)、医保类型(OR=5.590)、疾病认知(OR=4.406)、应对方式(OR=2.818)均与老年慢性心力衰竭患者健康促进行为有关(P<0.05)。随访患者6个月,健康促进行为达健康水平的患者心力衰竭再入院、心源性死亡、非致死性心肌梗死和靶血管血运重建发生率均低于健康促进行为未达健康水平的患者(P<0.05)。结论老年慢性心力衰竭患者需进一步改善健康促进行为,疾病认知与患者健康促进行为密切相关,健康促进行为可进一步影响患者不良心血管事件的发生。

Objective To investigate the changes of health promotion behavior in elderly patients with chronic heart failure,explore its relationship with disease cognition and adverse cardiovascular events,and provide a basis for guiding patients health promotion behavior.Methods Elderly patients with chronic heart failure admitted to Cardiac Rehabilitation Center of Beijing Rehabilitation Hospital Affiliated to Capital Medical University from June 2018 to June 2023 were selected as the investigation subjects.The General Information Questionnaire,Health Promotion Lifestyle Scale(HPLP-C),Atlanta Heart Failure Knowledge Questionnaire(AHFKT),and Simple Coping Styles Questionnaire(SCSQ)were used to evaluate the basic condition,health promotion behavior,disease cognition,and coping style of the patients.Multivariate Logistic regression was used to analyze the relationship between health promotion behavior and disease cognition.The patients were followed up for 6 months,and the incidence of adverse cardiovascular events was counted and analyzed.Results A total of 803 elderly patients with chronic heart failure were included.Among them,289 patients(35.99%)reached the healthy level of health promotion behavior,and 514 ones(64.01%)did not reach the healthy level.Multivariate Logistic results showed that education level(OR=8.637),per capita monthly family income(OR=5.414),living style(OR=3.827),type of medical insurance(OR=5.590),disease cognition(OR=4.406),coping style(OR=2.818)were all related to health promotion behavior in elderly patients with chronic heart failure(P<0.05).Conclusion Elderly patients with chronic heart failure need to further improve their health promotion behavior.Patients disease cognition is closely related to their health promotion behavior.Health promotion behavior can further influence the occurrence of adverse cardiovascular events in the patients.