慢性心力衰竭患者衰弱变化轨迹及其影响因素
Trajectories of frailty in patients with chronic heart failure and their influencing factors
丁华 1李朝凤 2程钰 1严静 3张瑜 2王岩岩 2张馨 2李云2
作者信息
- 1. 南京中医药大学护理学院(江苏南京,210023);南京中医药大学附属南京医院(南京市第二医院)
- 2. 南京中医药大学附属南京医院(南京市第二医院)
- 3. 南京中医药大学护理学院(江苏南京,210023)
- 折叠
摘要
目的 探索慢性心力衰竭患者衰弱变化轨迹及其影响因素,为针对性干预提供参考.方法 采用方便抽样法选取住院治疗的105例慢性心力衰竭患者,对其入院至出院后6个月期间分为4个时间点进行衰弱评估,了解衰弱变化轨迹,分析影响因素.结果 4个时间点患者衰弱评分分别为2(1,3)分、2(0.3)分、1(0,3)分、1(0,3)分;衰弱轨迹分为低水平缓降组(47.6％)、中水平下降组(18.1％)、中水平上升组(34.3％)3个潜类别;多分类logistic回归分析结果显示,年龄、身体质量指数、共病种数、血红蛋白、心功能分级、抑郁和体力活动是患者衰弱轨迹的影响因素(均P＜0.05).结论 慢性心力衰竭患者经住院治疗护理,衰弱水平总体呈好转趋势,衰弱轨迹分为3个潜类别,轨迹具有异质性;护理人员可针对不同类别、不同阶段及影响因素制定干预计划,实现精准护理.
Abstract
Objective To explore the trajectories of frailty and their influencing factors among patients with chronic heart failure(CHF),and to provide a reference for targeted intervention.Methods A total of 105 CHF patients were selected by convenience sampling method,and their frailty was assessed at four time points from admission to 6 months after discharge.The trajectory of frailty and influencing factors were determined.Results The median(P25-P75)of frailty score was 2(1,3),2(0,3),1(0,3),and 1(0,3)at four time points,respectively.Three distinct frailty trajectories were identified:low-level slow decline group(47.6％),medium-level decline group(18.1％),and medium-level rise group(34.3％).Multivariate logistic regression analysis revealed that age,body mass index,the number of co-morbidities,hemoglobin value,cardiac function grading,depression,and physical activity were the influencing factors for the frailty trajectories(all P＜0.05).Conclusion CHF patients,after inpatient treatment and nur-sing care,show an overall trend of improvement in frailty.There are three frailty trajectories,with significant heterogeneity in the trajectory.Frailty trajectories may offer a way to target individuals in different subgroups,at different periods and with different influencing factors for precise interventions.
关键词
慢性心力衰竭/衰弱/潜类别/抑郁/体力活动/营养/纵向研究/影响因素Key words
chronic heart failure/frailty/latent classes/depression/physical activity/nutrition/longitudinal study/in-fluencing factors引用本文复制引用
基金项目
2021年度南京市卫生科技发展专项资金项目(YKK21122)
出版年
2024
NETL
NSTL
万方数据