下肢动脉硬化闭塞症患者出院准备度现状及影响因素分析

Analysis on the current situation and influencing factors of discharge readiness of patients with arteriosclerosis obliterans

目的探讨下肢动脉硬化闭塞症患者出院准备度潜在类别,并分析其影响因素,为下肢动脉硬化闭塞症患者出院准备度个体化管理提供理论依据。方法采用便利抽样法,于2022年2—12月采用一般资料调查表、出院指导质量量表、家庭关怀度指数问卷对在山东第一医科大学附属省立医院血管外科接受外科治疗的下肢动脉硬化闭塞症患者194例进行横断面调查。采用潜在剖面分析识别不同类别,用Logistic回归分析探讨其影响因素。结果回收有效问卷182份。182例研究对象中男127例,女55例,>60岁患者居多,占81.9%(149/182)。本研究识别出3个潜在剖面模型,分别为低出院准备度组(27.47%)、中等出院准备度—高预期支持组(41.21%)、高出院准备度组(31.31%);Logistic回归分析表明,首次住院(OR=19.218,95%CI 2.949~125.237)、出院指导质量(OR=0.896,95%CI 0.857~0.937)是中等出院准备度-高预期支持组的预测因素(均P<0.05);家庭功能(OR=0.185,95%CI 0.097~0.353)、出院指导质量(OR=0.823,95%CI 0.764~0.888)是下肢动脉硬化闭塞症患者低出院准备度组的预测因素(均P<0.05)。结论下肢动脉硬化闭塞症患者出院准备度存在不同类别,出院指导质量低、家庭功能差的患者更有可能出现低出院准备度趋势;出院指导质量低、首次住院的患者更有可能出现中等出院准备度-高预期支持趋势。对该类患者,医务人员应采取相应的措施,提高其出院准备度。

Objective To explore the latent profile of discharge readiness of patients with lower extremity arteriosclerosis obliterans and analyze its influencing factors,so as to provide theoretical basis for individualized management of discharge readiness in patients with lower limb arteriosclerosis obliterans.Methods From February 2022 to December 2022,194 patients with arteriosclerosis obliterans of lower limbs who received surgical treatment in the vascular surgery department of Shandong Provincial Hospital Affiliated to Shandong First Medical University were investigated by using general information questionnaire,Readiness for Hospital Discharge Scale,Quality of Discharge Teaching Scale and Family APGAR Index for a cross-sectional survey.Latent profile analysis was used to identify different categories,and Logistic regression analysis was used to explore its influencing factors.Results Totally 182 valid questionnaires were collected,of which 127 males and 55 females,and patients over 60 years old were the majority,accounting for 81.9%.Three latent profile models were identified in this study,namely,low discharge readiness group(27.47%),medium discharge readiness-high expected support group(41.21%)and high discharge readiness group(31.31%).Logistic regression analysis showed that first hospitalization(OR=19.218,95%CI 2.949-125.237),the quality of discharge guidance(OR=0.896,95%CI 0.857-0.937)were the predictive factors of medium discharge readiness-high expected support group(P<0.05);family function(OR=0.185,95%CI 0.097-0.353)and the quality of discharge guidance(OR=0.823,95%CI 0.764-0.888)were the predictive factors of the low discharge readiness group of patients with arteriosclerosis obliterans(all P<0.05).Conclusions There are different types of discharge readiness of patients with arteriosclerosis obliterans,and patients with poor quality of discharge guidance and poor family function are more likely to have a trend of low discharge readiness.Patients with low quality discharge guidance and first hospitalization are more likely to have a trend of moderate discharge readiness-high expected support.For this kind of patients,medical staff should take corresponding measures to improve their readiness for discharge.