慢性心衰再同步治疗患者生活质量及其心理行为影响因素
Influencing Behavioral and Psychological Factors of Patients with Heart Failure Following Cardiac Resynchronization Therapy
DOI: 10.12677/NS.2017.62012, PDF, HTML, XML, 下载: 1,560  浏览: 2,963 
作者: 黄 靖：四川大学华西临床医学院，四川 成都；赵一衡：西双版纳职业技术学院，云南 西双版纳；方进博*：四川大学华西医院护理部，四川 成都
关键词: 心力衰竭；心脏再同步治疗；生活质量；心理行为因素；Heart Failure (HF)； Cardiac Resynchronization Therapy (CRT)； Quality of Life (QOL)； Psychological and Behavioral Factors
摘要: 目的：探索心脏再同步治疗术后患者生活质量现状，研究心理行为因素对其影响。方法：本研究为横断面研究，通过便利抽样选取成都市某三甲医院接受心脏再同步治疗的141名患者进行研究。采用Morisky服药依从性问卷、心脏病患者抑郁调查表和明尼苏达心衰竭生活质量量表对患者进行调查。结果：患者生活质量得分为(30.89 ± 12.11)。回归分析显示抑郁状态(β = 0.190, p = 0.014)、限水(β = 0.243, p = 0.028)、是否规律运动(β = 0.130, p = 0.086)是影响生活质量的心理行为因素。结论：本研究可了解心脏再同步治疗术后患者生活质量现状以及行为与心理因素对其影响，护理人员可以此为依据，提供针对性地护理措施，指导和管理患者术后的健康行为，以提高患者生活质量。
Abstract: Objective: To describe the status of quality of life and identify the psychological and behavioral factors of quality of life among patients with heart failure following Cardiac resynchronization therapy. Methods: This cross-sectional study recruited 141 patients with chronic heart failure following cardiac resynchronization therapy by convenient sampling. Patients completed questionnaires that included demographic data, the Morisky Medication Adherence Scale, the Cardiac Depression Scale, and the Minnesota Living With Heart Failure Questionnaire. Results: The average total score of Minnesota Living With Heart Failure Questionnaire was 30.89 ± 12.11. The quality of life was significantly influenced by depression (β = 0.190, p = 0.014), restrictions of fluid (β = 0.243, p = 0.028) and regular exercise (β = 0.130, p = 0.086). Conclusion: This paper describes the status of quality of life and defines the behavioral factors of quality of life of patients with chronic heart failure following cardiac resynchronization therapy. The results can guide clinical nurses to manage and carry out health education for patients, to improve their quality of life.
文章引用：黄靖, 赵一衡, 方进博. 慢性心衰再同步治疗患者生活质量及其心理行为影响因素[J]. 护理学, 2017, 6(2): 58-64. https://doi.org/10.12677/NS.2017.62012

参考文献

[1] Lloyd-Jones, D., Adams, R.J., Brown, T.M., et al. (2010) Executive Summary: Heart Disease and Stroke Statis-tics--2010 Update: A Report from the American Heart Association. Circulation, 121, 948-954.
https://doi.org/10.1161/CIRCULATIONAHA.109.192666
[2] 顾东风, 黄广勇. 中国心力衰竭流行病学调查及其患病率[J]. 中华心血管病杂志, 2003, 31(1): 3-6.
[3] Jaffe, L.M. and Morin, D.P. (2014) Cardiac Resynchronization Therapy: History, Present Status, and Future Directions. The Ochsner Journal, 14, 596-607.
[4] Lenarczyk, R., Jedrzejczyk-Patej, E., Mazurek, M., et al. (2015) Quality of Life in Cardiac Resynchronization Recipients: Association with Response and Impact on Outcome. Pacing and Clinical Electrophysiology: PACE, 38, 8-17.
https://doi.org/10.1111/pace.12523
[5] Tierney, S., Mamas, M., Skelton, D., et al. (2011) What Can We Learn from Patients with Heart Failure about Exercise Adherence? A Systematic Review of Qualitative Papers. Health Psychology, 30, 401-410.
https://doi.org/10.1037/a0022848
[6] Faller, H., Steinb Chel, T., St Rk, S., et al. (2010) Impact of Depression on Quality of Life Assessment in Heart Failure. International Journal of Cardiology, 142, 133.
https://doi.org/10.1016/j.ijcard.2008.12.093
[7] Hoth, K.F., Nash, J., Poppas, A., et al. (2008) Effects of Cardiac Resynchronization Therapy on Health-Related Quality of Life in Older Adults with Heart Failure. Clinical Interventions in Aging, 3, 553-560.
https://doi.org/10.2147/CIA.S1823
[8] Conraads, V.M., Vanderheyden, M., Paelinck, B., et al. (2007) The Effect of Endurance Training on Exercise Capacity Following Cardiac Resynchronization Therapy in Chronic Heart Failure Patients: A Pilot Trial. European Journal of Cardiovascular Prevention and Rehabilitation: Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology, 14, 99-106.
https://doi.org/10.1097/HJR.0b013e32801164b3
[9] 戴俊明, 傅华. 原发性高血压药物治疗依从性研究[J]. 中国慢性病预防与控制, 2000, 8(3): 143-5.
[10] Wang, W., Ski, C.F., Thompson, D.R., et al. (2011) A Psychometric Evaluation of the Chinese Version of the Short-Form Cardiac Depression Scale. Psychosomatics, 52, 450-454.
https://doi.org/10.1016/j.psym.2011.04.003
[11] 朱燕波, 杜金行, 林琳, 等. 明尼苏达心功能不全生命质量量表中文版的研制及临床试用[J]. 中华行为医学与脑科学杂志, 2010(2): 178-81.
[12] Xu, G.J., Gan, T.Y., Tang, B.P., et al. (2013) Predictive Factors and Clinical Effect of Optimized Cardiac Resynchronization Therapy. Experimental and Therapeutic Medicine, 5, 355-361.
[13] Laksman, Z., Yee, R., Stirrat, J., et al. (2014) Model-Based Navigation of Left and Right Ventricular Leads to Optimal Targets for Cardiac Resynchronization Therapy: A Single Centre Feasibility Study. Circulation: Arrhythmia and Electrophysiology, CIRCEP, 114, 001729.
[14] Seto, E., Leonard, K.J., Cafazzo, J.A., et al. (2011) Self-Care and Quality of Life of Heart Failure Patients at a Multidisciplinary Heart Function Clinic. Journal of Cardiovascular Nursing, 26, 377-385.
https://doi.org/10.1097/JCN.0b013e31820612b8
[15] 贺小兰, 徐英, 游桂英. 心脏再同步化治疗术后患者生存质量及心理状况的调查研究[J]. 华西医学, 2015, 30(4): 732-5.
[16] 孙路路. 出院心力衰竭患者预后状况及影响因素的研究[D]; 北京协和医学院 中国医学科学院 北京协和医学院 清华大学医学部 中国医学科学院, 2012.
[17] Ford, J., Sears, S., Ramza, B., et al. (2014) The Registry Evaluating Functional Outcomes of Resynchronization Management (REFORM): Quality of Life and Psychological Functioning in Patients Receiving Cardiac Resynchronization Therapy. Journal of Cardiovascular Electrophysiology, 25, 43-51.
https://doi.org/10.1111/jce.12257
[18] Friedmann, E., Thomas, S.A., Liu, F., et al. (2006) Relationship of De-pression, Anxiety, and Social Isolation to Chronic Heart Failure Outpatient Mortality. American Heart Journal, 152, e1-8.
https://doi.org/10.1016/j.ahj.2006.05.009
[19] 黄丽, 程婧, 吴继雄, 等. 延续护理对心脏再同步化治疗患者心功能、生存质量和心理状态的影响[J]. 第三军医大学学报, 2014(3): 292-293.
[20] Belardinelli, R., Capestro, F., Misiani, A., et al. (2006) Moderate Exercise Training Improves Functional Capacity, Quality of Life, and Endothe-lium-Dependent Vasodilation in Chronic Heart Failure Patients with Implantable Cardioverter Defibrillators and Cardiac Resynchronization Therapy. European Journal of Cardiovascular Prevention and Rehabilitation: Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology, 13, 818-825.
https://doi.org/10.1097/01.hjr.0000230104.93771.7d
[21] Haennel, R.G. (2012) Exercise Rehabilitation for Chronic Heart Failure Patients with Cardiac Device Implants. Cardiopulmonary Physical Therapy Journal, 23, 23-28.

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