心力衰竭患者症状群及健康素养对生活质量的影响研究-现代医学

心力衰竭患者症状群及健康素养对生活质量的影响研究

作者：姚倩¹ 陈旭姝¹ 罗健¹ 杨锦¹ 宋宝梅² 田维² 王天轶¹ 李秀川² 杨拯¹ 3

单位：1. 成都医学院护理学院, 四川成都 610083;
2. 西部战区总医院心内科, 四川成都 610083;
3. 成都医学院基础医学院, 四川成都 610500

分类号：R541.6

出版年·卷·期（页码）：2024·52·第三期（350-357）

摘要：

目的：评估心力衰竭(HF)患者的症状群、健康素养和生活质量现状，并分析三者间的相关性，探讨症状群及健康素养对生活质量的影响。方法：采用方便抽样法，纳入2022年12月至2023年7月成都市某3所三甲医院心内科就诊的310例HF患者。使用一般资料调查表、心衰记忆症状评估量表(MSAS-HF)、中文版心衰患者特异性健康素养量表、明尼苏达心衰生活质量调查问卷(MLHFQ)评估HF患者的症状群、健康素养和生活质量。使用探索性因子分析HF患者的症状群，采用Pearson相关分析法分析症状群及健康素养与生活质量的相关性，应用多元线性回归分析症状群及健康素养对生活质量的影响。结果：共分析出5个症状群，分别是消化症状群(缺乏食欲、口干、体重下降、恶心、腹胀)、情绪症状群(哀伤感、忧虑、易怒、感觉紧张)、呼吸困难症状群(气短、平躺时呼吸困难、夜间睡眠憋醒、没劲、睡眠困难)、缺血症状群(头晕、胸痛、心悸、手脚麻木)和淤血症状群(咳嗽、水肿)。健康素养得分为(23.88±9.03)分，生活质量得分为(49.16±12.98)分。5个症状群得分与生活质量得分均呈正相关(r=0.456、0.356、0.311、0.152、0.348, P＜0.01)，健康素养得分与生活质量得分呈负相关(r=-0.356, P＜0.01)。多元线性回归分析显示，婚姻状况、平均月收入、心功能分级、消化、情绪、呼吸困难、淤血症状群以及健康素养是患者生活质量的影响因素(P＜0.05)。结论：HF患者的生活质量受多种症状群以及健康素养的影响，提高患者的生活质量可从症状群以及健康素养作为切入点，减轻患者症状，提高健康素养水平。

Objective: To evaluate the status of symptom clusters, health literacy and quality of life in patients with heart failure(HF), and analyze their correlation, explore the impact of symptom clusters and health literacy on quality of life.Methods: A convenient sampling method was used to select 310 HF patientswho were treated in the department of cardiology of a three-A hospital in Chengdu from December 2022 to July 2023 as the study subjects. The current status of symptom clusters, health literacy and quality of life in HF patients was assessed using the general information questionnaire, the Memorial Symptom Assessment Scale for Heart Failure(MSAS-HF), the Chinese version of the Heart Failure Specific Health Literacy Scale and the Minnesota Living with Heart Failure Questionnaire(MLHFQ). Exploratory factor analysis was used to analyze the symptom clusters of HF patients. Pearson analysis was used to analyze the correlation between symptom clusters, health literacy and quality of life. Multiple linear regression analysis was used to explore the impact of symptom clusters and health literacy on quality of life.Results: A total of five symptom clusters were analyzed, which were digestive symptom cluster(lack of appetite, dry mouth, weight loss, nausea, abdominal distension), emotional symptom cluster(sadness, anxiety, irritability, feeling nervous), dyspnea symptom cluster(shortness of breath, difficulty in breathing while lying down, sleep at night and wake up, lack of strength, difficulty in sleeping), ischemic symptom cluster(dizziness, chest pain, palpitation, numbness of hands and feet) and congestion symptom cluster(cough, edema).The health literacy score was 23.88±9.03, and the quality of life score was 49.16±12.98.The five symptom cluster scores were positively correlated with the quality of life scores(r=0.456, 0.356, 0.311, 0.152, 0.348, P＜0.01), and the health literacy score was negatively correlated with the quality of life score(r=-0.356, P＜0.01). Multiple linear regression analysis showed that marital status, average monthly income, cardiac function classification, digestion, mood, dyspnea, bruising symptom clusters, and health literacy were the influencing factors of patients' quality of life(P＜0.05).Conclusion: The quality of life of HF patientsis affected by a variety of symptom clusters and health literacy. Improving the quality of life of patients can take symptom clusters and health literacy as an entry point to alleviate the symptoms of patients and improve the level of health literacy.

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