心房颤动患者射频消融术后参与运动康复障碍和促进因素的混合研究

Barriers and facilitators for exercise rehabilitation in patients with atrial fibrillation after radiofrequency ablation:a mixed study

目的:探讨心房颤动(房颤)患者射频消融术后参与运动康复的障碍和促进因素。方法:采用便利抽样法,2022年3-8月从南京医科大学第一附属医院心血管内科"云病房"招募房颤射频消融术后3个月内的285例患者为研究对象,采用心脏康复障碍量表评估患者参与运动康复的障碍、运动自我效能感量表评估患者的运动自我效能。对其中的22例患者进行半结构化访谈,提炼主题。结果:285例房颤患者中,参与过运动康复项目者202例(70.88%)。研究显示,工作/时间冲突、缺乏心脏康复知识、健康/躯体功能受限影响患者运动康复参与情况( P<0.05)。质性研究提炼出3个影响患者运动康复情况的主题:能力、机会和动机。 结论:房颤患者运动康复参与受到家庭责任、能力、动机、机会多因素影响。医务人员应综合考虑以上因素,全方位、多角度、针对性地制定相应的干预措施,切实改善患者的运动康复参与情况。

ObjectiveTo explore the barriers and facilitators of exercise rehabilitation in patients with atrial fibrillation(AF)after radiofrequency ablation.MethodsFrom March to August 2022,285 patients with atrial fibrillation who underwent radiofrequency ablation within three months were recruited from the"Cloud Ward"of the Department of Cardiovascular of the First Affiliated Hospital with Nanjing Medical University by convenience sampling.The Cardiac Rehabilitation Barriers Scale(CRBS)and the Self-efficacy for Exercise Scale(SEE)were used to evaluate the barriers and self-efficacy of patients participating in exercise rehabilitation,respectively.Among them,22 patients were subjected to semi-structured interviews to extract themes.ResultsAmong 285 patients with atrial fibrillation,202(70.88%)participated in exercise rehabilitation programs.Work/time conflicts,lack of cardiac rehabilitation knowledge,and health/physical function limitations affected the participation of patients in exercise rehabilitation(P<0.05).Qualitative research extracted three themes that affected the patient's exercise rehabilitation,including capability,opportunity,and motivation.ConclusionsThe participation of atrial fibrillation patients in exercise rehabilitation is influenced by multiple factors such as family responsibility,capability,motivation,and opportunity.Medical and nursing staff should comprehensively consider the above factors,develop targeted interventions from all aspects and multiple angles,so as to effectively improve the participation of patients in exercise rehabilitation.