房颤冷冻球囊消融术患者心脏康复信息需求及影响因素分析

Information needs and influencing factors of cardiac rehabilitation in patients undergoing cryobaiioon ablation for atrial fibrillation

目的探讨房颤冷冻球囊消融术(CBA)患者心脏康复信息需求的变化,分析不同轨迹类别的影响因素,以期为患者的康复指导提供一定参考。方法采用便利抽样法,选取2022年1月—2023年4月在西安交通大学第一附属医院心内科拟行CBA的患者为研究对象。分别于术前1 d(T0)、术后1个月(T1)、术后3个月(T2)及术后6个月(T3)采用心脏康复信息需求量表对患者进行调查。结果本研究共发放问卷257份,回收有效问卷218份。218例患者在T0、T1、T2和T3时间点的心脏康复信息需求量表的总分分别为(187.86±35.28)、(183.27±34.98)、(174.03±34.01)和(167.35±33.96)分。218例患者不同时间点的心脏康复信息需求量表总分比较差异有统计学意义(F=18.237,P<0.01)。可拟合4个潜在轨迹类别,分别为持续中高需求组(40.83%,89/218)、中高需求-下降组(36.70%,80/218)、中低需求-改善组(7.34%,16/218)和中低需求-下降组(15.14%,33/218)。年龄、是否合并基础慢性病、居住地、社会支持和是否有术后并发症是房颤患者心脏康复信息需求潜在轨迹类别的影响因素(P<0.05)。结论医护人员应尽早判断患者心脏康复信息需求的发展轨迹,强调心脏康复重要性,建立远程可操控式的心脏康复方案,鼓励农村居住地患者参与当地社区相关心脏康复活动,调动患者的社会支持资源,改善其对心脏康复的需求和依从性。

Objective To explore the changes in cardiac rehabilitation information needs of patients undergoing cryobaiioon ablation(CBA)for atrial fibrillation,analyze the influencing factors of different trajectory categories,so as to provide reference for rehabilitation guidance.Methods From January 2022 to April 2023,convenience sampling was used to select patients who were planning to undergo CBA in the Cardiovascular Department at the First Affiliated Hospital of Xi'an Jiaotong University as participants.Patients were surveyed using the Information Needs in Cardiac Rehabilitation Scale at one day before surgery(T0),one month after surgery(T1),three months after surgery(T2),and six months after surgery(T3).Results A total of 257 questionnaires were distributed,and 218 valid questionnaires were collected.The total scores of the Information Needs in Cardiac Rehabilitation Scale for 218 patients at T0,T1,T2,and T3 were(187.86±35.28),(183.27±34.98),(174.03±34.01),and(167.35±33.96),respectively.There was a statistically significant difference in the total scores of the Information Needs in Cardiac Rehabilitation Scale among 218 patients at different time points(F=18.237,P<0.01).Four potential trajectory categories were fitted,namely the sustained medium high need group(40.83%,89/218),the medium high need-decline group(36.70%,80/218),the medium low need-improvement group(7.34%,16/218),and the medium low need-decline group(15.14%,33/218).Age,whether to merge underlying chronic diseases,place of residence,social support,and postoperative complications were potential trajectory factors affecting the cardiac rehabilitation information needs of atrial fibrillation patients(P<0.05).Conclusions Medical and nursing staff should assess the development trajectory of patients'cardiac rehabilitation information needs as early as possible,emphasize the importance of cardiac rehabilitation,establish remote and controllable cardiac rehabilitation programs,encourage rural residents to participate in local community related cardiac rehabilitation activities,mobilize patients'social support resources,and improve their needs and compliance with cardiac rehabilitation.