急性冠脉综合征患者经皮冠状动脉介入术后运动恐惧的潜在剖面分析

Potential profile analysis of kinesiophobia in patients with acute coronary syndrome after percutaneous coronary intervention

目的探讨急性冠脉综合征(ACS)患者经皮冠状动脉介入(PCI)术后运动恐惧的潜在类别特征及影响因素。方法采用便利抽样法选取接受PCI治疗的360例ACS患者作为调查对象,采用一般资料调查表、心脏病患者运动恐惧量表(TSK⁃SV Heart)、多维度运动自我效能量表(MSES)、修订版事件影响量表(IES⁃R)及社会支持评定量表(SSRS)对其进行调查。运用潜在剖面分析探索ACS患者PCI术后运动恐惧的潜在类别。基于潜在类别分析结果,采用多分类Logistic回归模型分析ACS患者PCI术后运动恐惧的影响因素。结果360例ACS患者的TSK⁃SV Heart总分为(42.94±7.92)分,其中71.1%(256/360)的患者存在运动恐惧。通过潜在剖面分析,可将ACS患者PCI术后运动恐惧划分为低运动恐惧、中等运动恐惧和高运动恐惧3个潜在类别。多分类Logistic回归分析结果显示,受教育程度、合并症数量、心功能分级、D型人格、运动自我效能(MSES总分)、事件影响程度(IES⁃R总分)及社会支持水平(SSRS总分)是ACS患者PCI术后不同程度运动恐惧的影响因素(P<0.05)。结论ACS患者PCI术后运动恐惧整体处于较高水平,且具有明显的分类特征。运动自我效能、事件影响程度及社会支持水平等多个因素可影响ACS患者PCI术后运动恐惧水平。医护人员应根据不同类别运动恐惧患者的特点制订并实施有针对性的健康指导和干预措施,以降低患者的运动恐惧水平,提升其开展运动康复的积极性。

Objective To investigate the potential category features and influencing factors of kinesiophobia in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods A total of 360 ACS patients receiving PCI for treatment were selected as the investigation subjects by employing the convenience sampling method.The general information inventory,Tampa Scale for Kinesiophobia⁃Heart(TSK⁃SV Heart),Multidimensional Self⁃Efficacy for Exercise Scale(MSES),Impact of Event Scale⁃Revised(IES⁃R),and Social Support Rating Scale(SSRS)were perform on them for investigation.The potential profile analysis was used to explore the potential categories of kinesiophobia in ACS patients after PCI.On the basis of the results of potential category analysis,the influencing factors for kinesiophobia in ACS patients after PCI were analyzed by using the multinomial Logistic regression model.Results The total score of TSK⁃SV Heart among 360 ACS patients was 42.94±7.92,therein 71.1%(256/360)of patients had kinesiophobia.Through potential profile analysis,kinesiophobia in ACS patients after PCI was assigned to the 3 potential categories of low kinesiophobia,medium kinesiophobia,and high kinesiophobia.The results of multinomial Logistic regression analysis revealed that educational level,number of comorbidity,cardiac function classification,type D personality,self⁃efficacy for exercise(MSES total score),impact degree of events(IES⁃R total score),and social support level(SSRS total score)were the influencing factors for different degrees of kinesiophobia in ACS patients after PCI(P<0.05).Conclusion Kinesiophobia of ACS patients after PCI is at a relatively high level,and it has prominent category features.Multiple factors such as self⁃efficacy for exercise,impact degree of events,and social support level can affect kinesiophobia level of ACS patients after PCI.Medical and nursing staff should formulate and implement targeted health guidance and intervention measures according to the features of patients with different types of kinesiophobia,so as to decrease the level of kinesiophobia of patients and improve their positivity for carrying out exercise rehabilitation.