老年慢性心力衰竭患者居家生活空间纵向变化及潜在剖面分析

Longitudinal Changes and Latent Profile Analysis on Life Space of Elderly Patients with Chronic Heart Failure

目的探讨老年慢性心力衰竭(CHF)患者居家生活空间纵向变化特征,并分析其潜在剖面类别和影响因素。方法2022年1月至2023年1月,采用方便抽样方法选取收治于上海市浦东新区老年医院心内科的110例住院老年CHF患者作为研究对象。采用一般资料调查表、生活空间评估量表(LSA)对其进行调查,并采用Mplus 8.3软件对其居家生活空间特征进行潜在剖面分析,通过单因素分析和多因素logistic回归分析老年CHF患者生活空间潜在类别影响因素。结果老年CHF患者生活空间剖面分为生活空间持续受限组(n=33)、生活空间部分改善组(n=62)和生活空间显著改善组(n=15)3个潜在类别;logistic回归分析结果显示,年龄、独居是老年CHF患者生活空间部分改善的影响因素(均P<0.05),年龄、认知功能障碍是老年CHF患者生活空间显著改善的影响因素(均P<0.05)。结论老年CHF患者居家生活空间存在异质性,可分为3个潜在类别,年龄、独居和认知功能障碍等因素对生活空间的改善有显著影响。医护人员应在老年CHF患者出院前为其提供个性化的居家心脏康复方案指导,尤其为独居和认知功能障碍的患者及其家属提供必要的支持和培训,以提升其居家生活空间水平。

Objective To explore the longitudinal changes in the life space of elderly patients with chronic heart failure(CHF)and analyze the latent profile classes and influencing factors.Methods From January 2022 to January 2023,110 elderly inpatients with CHF were selected by convenience sampling who were admitted to the Cardiology Department of Shanghai Pudong New Area Geriatric Hospital.They were investigated using the General Information Questionnaire and Life-Space Assessment(LSA).The latent profile analysis on the characteristics of their life space was performed using Mplus 8.3 software.The latent classes and influencing factors of the life space of elderly patients with CHF were analyzed by univariate analysis and multivariate logistic regression.Results The life space profile of elderly CHF patients was divided into three latent classes:persistent limited life space(n=33),partially improved life space(n=62)and significantly improved life space(n=15).Logistic regression analysis identified age and living alone as influencing factors for elderly CHF patients with partially improved life space(both P<0.05),and age and cognitive dysfunction as influencing factors for elderly CHF patients with significantly improved life space(both P<0.05).Conclusion Life space is heterogeneous among elderly CHF patients,which can be divided into three latent classes.Factors such as age,living alone and cognitive dysfunction have significant impact on the improvement of living space.Healthcare providers should provide individualized guidance on home-based cardiac rehabilitation for elderly CHF patients before they are discharged from hospital.In particular,necessary support and training should be provided to patients living alone and those with cognitive dysfunction,along with their families,to improve their life space.