永久性心脏起搏器植入术后患者运动恐惧的潜在剖面分析

Potential profile analysis of fear of movement in patients after permanent cardiac pacemaker implantation

目的探索永久性心脏起搏器植入术后患者运动恐惧的特征差异及影响因素。方法于2023年1月至2024年4月采用回顾性研究方法,选取河南省南阳市中心医院369例初次行永久性心脏起搏器植入的患者为研究对象,采用一般资料调查表、心脏病患者运动恐惧量表、运动自我效能量表调查,运用潜在剖面分析识别患者运动恐惧的潜在类别,通过有序logistic回归模型分析其影响因素。结果永久性心脏起搏器植入术后患者运动恐惧可分3个潜在类别:低水平运动恐惧组(16.0%)、中水平运动恐惧组(56.4%)、高水平运动恐惧组(27.6%)。单因素分析显示,性别、文化程度、居住地、家庭月收入、心功能分级、疼痛程度、运动自我效能在不同类别中比较,差异有统计学意义(P<0.05)。回归分析结果显示,女性(OR=2.218,P=0.039)、小学及以下(OR=4.170,P=0.002)是运动恐惧潜在类别的危险因素;城镇(OR=0.423,P=0.032)、运动自我效能高(OR=0.046,P<0.001)是运动恐惧潜在类别的保护因素。结论永久性心脏起搏器植入术后患者运动恐惧水平存在显著异质性,医护人员可根据不同潜在类别和影响因素,实施精准干预,降低患者术后运动恐惧水平。

Objective To explore the characteristic differences and influencing factors of motor fear in patients after permanent pacemaker implantation.Methods From January 2023 to April 2024,369 patients with the first permanent pacemaker implantation in Nanyang Central Hospital were selected as the research subjects,and the general data questionnaire,the tampa scale for kinesiophobia heart,and the self-efficacy for exercise scale survey were used.Identify the potential categories of patients’motor fear in the section analysis,and analyse their influencing factors through an orderly logistic regression model.Results After permanent pacemaker implantation,patients with motor fear were divided into three potential categories:low-level exercise fear group(16.0%),medium-level exercise fear group(56.4%),and high-level exercise fear group(27.6%).Single-factor analysis shows that gender,education level,place of residence,monthly family income,cardiac function classification,pain degree,and exercise self-efficacy were statistically significant compared in different categories(P<0.05).The regression analysis results show that women(OR=2.218,P=0.039),primary school and below(OR=4.170,P=0.002)were risk factors in the potential profile of sports fear;urban(OR=0.423,P=0.032),high motor self-efficacy(OR=0.046,P<0.001)were protective factors in the potential profile of sports fear.Conclusion There is significant heterogeneity in the exercise fear level of patients after permanent pacemaker implantation.Medical staff can carry out precise intervention according to different potential categories and influencing factors to reduce the postoperative exercise fear level of patients.