经皮冠状动脉介入术后病人运动恐惧分型及其影响因素

Study on the classification of kinesiophobia and its influencing factors in PCI patients

目的:描述经皮冠状动脉介入(PCI)术后病人运动恐惧水平,探讨PCI术后病人运动恐惧的潜在类别,分析不同类别PCI术后病人运动恐惧的差异,并探究这些潜在类别的影响因素。方法:于2023年8月—12月,采用便利抽样法选取在上海市3所三级甲等医院心内科住院治疗的342例PCI术后病人为调查对象,采用一般资料调查表、心脏疾病运动恐惧量表、运动自我效能量表和4条目病人健康问卷进行调查。结果:共调查327例PCI术后病人,病人心脏疾病运动恐惧量表总分为(36.21±5.81)分,处于中等水平;运动自我效能量表得分为(50.56±26.60)分,处于中等水平。PCI术后病人运动恐惧分为运动恐惧-担忧心脏危险组、广泛低运动恐惧水平组、运动恐惧-逃避运动组和运动恐惧-身心功能下降组4种不同潜在类别。病人运动自我效能水平、运动习惯、性别和冠心病运动知识掌握程度是PCI术后病人运动恐惧不同潜在类别的影响因素(均P<0.05)。知识掌握程度较好的病人及男性病人是运动恐惧-担忧心脏危险组的危险因素;运动自我效能高及有运动规律但不频繁(每次运动间隔时间2周至1个月)是运动恐惧-身心功能下降组的保护因素;运动自我效能高是运动恐惧-担忧心脏危险组和运动恐惧-逃避运动组的保护因素。结论:PCI术后病人运动恐惧具有明显的人群异质性,医护人员应根据其不同类别采取针对性的干预措施以降低特异性群体的运动恐惧水平。

Objective:To describe the level of PCI patients'kinesiophobia,to explore potential categories of PCI patients'kinesiophobia,and to analyze differences in these categories.Methods:From August 2023 to December 2023,a convenient sampling method was used to select 342 PCI patients from 3 tertiary hospitals in Shanghai.The questionnaire included the General Information Questionnaire,the Tampa Scale for Kinesiophobia Heart,Chinese Self-Efficacy for Exercise Scaleand Patient Health Questionnaire-4.Results:A total of 327 patients were included.The score of PCI patients'TSK-SV Heart was(36.21±5.81),which was at a medium level;the score of SEE-C was(50.56±26.60),which was at a medium level.According to the model fitting results,four latent classes were finally determined,which were kinesiophobia-perceived danger for heart problem,low level of kinesiophobia,kinesiophobia-avoidance of exercise and kinesiophobia-dysfunctional self.Exercise self-efficacy,exercise habits,gender and exercise knowledge of coronary heart disease were four factors affecting different latent classes of PCI patients'kinesiophobia.Better knowledge and male patients were risk factors for the group of kinesiophobia-perceived danger for heart problem;High exercise self-efficacy and regular exercise but not frequent(the interval between each exercise was from 2 weeks to 1 month)were protective factors for the group of kinesiophobia-dysfunctional self;high exercise self-efficacy was the protective factor for the group of kinesiophobia-perceived danger for heart problem and the group of kinesiophobia-avoidance of exercise.Conclusion:Kinesiophobia of PCI patients has distinct categorical features.It is suggested that healthcare professionals can adopt targeted interventions according to the characteristics of different classes to reduce the level of kinesiophobia.