稳定期慢性心力衰竭患者久坐行为现状及影响因素分析

许静; 张会; 仲蕾; 陆雅维; 项晓婷

doi:10.16766/j.cnki.issn.1674-4152.003622

稳定期慢性心力衰竭患者久坐行为现状及影响因素分析

doi: 10.16766/j.cnki.issn.1674-4152.003622

许静^{1, 2, 3},
张会^{2, 3, ,},
仲蕾¹,
陆雅维¹,
项晓婷¹

1.
安徽医科大学护理学院，安徽合肥 230601
2.
安徽医科大学第一附属医院护理部，安徽合肥 230032
3.
安徽省公共卫生临床中心护理部, 安徽合肥 230032

基金项目:

国家重点研发计划课题横向合作基金项目 2020YFC2006502

详细信息

通讯作者:
张会，E-mail：zhanghui310@126.com

中图分类号: R541.6
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- 文章访问数: 1
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- 被引次数: 0
出版历程
- 收稿日期: 2023-12-13
- 网络出版日期: 2024-11-19

Current status and influencing factors of sedentary behavior in patients with stable chronic heart failure

XU Jing^{1, 2, 3},
ZHANG Hui^{2, 3
, ,},
ZHONG Lei¹,
LU Yawei¹,
XIANG Xiaoting¹

1.
School of Nursing, Anhui Medical University, Hefei, Anhui 230601, China

摘要

摘要: 目的了解稳定期慢性心力衰竭患者久坐行为的现状, 并分析其影响因素, 为后期制定针对性的干预措施提供理论依据。方法采取方便抽样法，选取2023年4—10月在安徽医科大学第一附属医院心血管内科门诊就诊的196例慢性心力衰竭患者，采用一般资料问卷、国际体力活动短问卷(IPAQ-SF)、Barthel指数(BI)、心脏康复锻炼自我效能量表(CESEI)、社会支持评定量表(SSRS)、抑郁自评量表(SDS)进行调查，运用logistic回归分析探讨其影响因素。结果稳定期慢性心力衰竭患者日均久坐行为时间为(8.19±2.71)h，131例(66.84%)患者的久坐行为总时间>6 h。单因素结果显示，不同性别、年龄、BMI、受教育程度、近一年内加重次数、依赖程度、心功能分级、抑郁状况、心脏康复锻炼自我效能评分及社会支持评分的稳定期慢性心力衰竭患者久坐行为比较，差异均有统计学意义(P＜0.05)。Logistic回归分析显示, 年龄(OR=1.964，P=0.001)、BMI(OR=0.474，P=0.007)、心功能分级(OR=3.854，P=0.001)、心脏康复锻炼自我效能(OR=0.940，P=0.027)、抑郁(OR=2.863，P=0.009)是稳定期慢性心力衰竭患者久坐行为的影响因素。结论稳定期慢性心力衰竭患者久坐时间较长，久坐行为较为普遍。未来医护人员可采取有效干预措施，以降低患者的久坐行为时间，改善其预后。
- 慢性心力衰竭 /
- 久坐行为 /
- 心脏康复锻炼自我效能 /
- 影响因素
Abstract: Objective To understand the current status of sedentary behavior in patients with stable chronic heart failure (CHF) and analyze its influencing factors, to provide a theoretical basis for formulating targeted intervention measures in the later stage. Methods A total of 196 patients with chronic heart failure who visited the outpatient department of Cardiovascular Medicine in the First Affiliated Hospital of Anhui Medical University from April 2023 to October 2023 were selected by the convenient sampling method. The general information questionnaire, international physical activity questionnaire short form (IPAQ-SF), Barthel index (BI), cardiac exercise self-efficacy instrument (CESEI), social support rating scale (SSRS), and self-rating depression scale (SDS) were used to investigate, logistic regression was used to explore the influencing factors. Results The average daily sedentary time of the stable chronic heart failure patients was (8.19±2.71) h, and the total sedentary behavior time of 131 patients (66.84%) was more than 6 hours. Univariate results showed that there were statistically significant differences in sedentary behavior among chronic heart failure patients with different genders, age, BMI, education level, number of exacerbations in the past year, degree of dependence, cardiac function classification, depression degree, self-efficacy score of cardiac rehabilitation exercise and social support score (P < 0.05), logistic regression analysis showed that age (OR=1.964, P=0.001), BMI (OR=0.474, P=0.007), heart function grade of NYHA (OR=3.854, P=0.001), self-efficacy of cardiac rehabilitation exercise (OR=0.940, P=0.027) and depression (OR=2.863, P=0.009) were the influencing factors of sedentary behavior in patients with stable chronic heart failure. Conclusion The sedentary time of patients with stable chronic heart failure is longer, and sedentary behavior is common. In the future, medical staff can take effective interventions to reduce the sedentary behavior of patients and improve their prognosis.
- Chronic heart failure /
- Sedentary behavior /
- Self-efficacy of cardiac rehabilitation exercise /
- Influencing factors

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表 1 稳定期CHF患者久坐行为的单因素分析

Table 1. Univariate analysis of sedentary behavior in patients with stable chronic heart failure

项目	例数	非久坐(n=65)	久坐(n=131)	统计量	P值
性别[例(%)]				3.942^a	0.047
男性	107	42(39.3)	65(60.7)
女性	89	23(25.8)	66(74.2)
年龄[例(%)]				-5.792^b	＜0.001
≤59岁	29	17(58.6)	12(41.4)
60~岁	43	29(67.4)	14(32.6)
70~岁	69	10(14.5)	59(85.5)
≥80岁	55	9(16.4)	46(83.6)
BMI[例(%)]				-4.139^b	＜0.001
＜18.5	77	18(23.4)	59(76.6)
18.5~23.9	78	19(24.4)	59(75.6)
≥24.0	41	28(68.3)	13(31.7)
婚姻[例(%)]				3.168^a	0.075
已婚	165	59(35.8)	106(64.2)
未婚/离异/丧偶	31	6(19.4)	25(80.6)
居住方式[例(%)]				2.444^a	0.118
非独居	143	52(36.4)	91(63.6)
独居	53	13(24.5)	40(75.5)
家庭人均月收入[例(%)]				-1.500^b	0.134
＜3 000元	115	34(29.6)	81(70.4)
3 000~5 000元	68	24(35.3)	44(64.7)
＞5 000元	13	7(53.8)	6(46.2)
医保方式[例(%)]				3.823^a	0.149
自费	29	11(37.9)	18(62.1)
职工	49	21(42.9)	28(57.1)
居民	118	33(28.0)	85(72.0)
受教育程度[例(%)]				-2.083^b	0.037
小学及以下	140	41(29.3)	99(70.7)
中学/中专	42	15(35.7)	27(64.3)
大专及以上	14	9(64.3)	5(35.7)
病程[例(%)]				3.307^a	0.069
＜5年	118	45(38.1)	73(61.9)
≥5年	78	20(25.6)	58(74.4)
非心血管合并症[例(%)]				3.138^a	0.076
＜3个	100	39(39.0)	61(61.0)
≥3个	96	26(27.1)	70(72.9)
近一年内加重次数[例(%)]				-2.517^b	0.012
≤1次	51	20(39.2)	31(60.8)
2次	94	37(39.4)	57(60.6)
≥3次	51	8(15.7)	43(84.3)
心功能分级[例(%)]				23.275^a	＜0.001
Ⅱ级	88	45(51.1)	43(48.9)
Ⅲ级	108	20(18.5)	88(81.5)
健康自评[例(%)]				-1.407^b	0.159
好	34	11(32.4)	23(67.6)
中	83	34(41.0)	49(59.0)
差	79	20(25.3)	59(74.7)
依赖程度[例(%)]				-2.242^b	0.025
轻度依赖/独立	153	57(37.3)	96(62.7)
中度依赖	29	5(17.2)	24(82.8)
重度依赖	14	3(21.4)	11(78.6)
抑郁状况[例(%)]				-4.293^b	＜0.001
正常	137	59(43.1)	78(56.9)
轻度	42	3(7.1)	39(92.9)
中重度	17	3(17.6)	14(82.4)
CESEI得分(x±s，分)		54.58±6.87	50.47±7.97	3.562^c	＜0.001
SSRS得分M(P₂₅, P₇₅)，分]		30.00(27.00，33.00)	28.00(26.00，31.00)	-3.137^b	0.002
注：^a为χ²值，^b为Z值，^c为t值。

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表 2 稳定期CHF患者久坐行为的logistic回归分析

Table 2. Logistic regression analysis of sedentary behavior in patients with stable chronic heart failure

变量	B	SE	Waldχ²	P值	OR值	95% CI
年龄	0.675	0.209	10.400	0.001	1.964	1.303~2.960
BMI	-0.746	0.275	7.352	0.007	0.474	0.276~0.813
心功能分级	1.349	0.408	10.960	0.001	3.854	1.734~8.566
抑郁状况	1.052	0.405	6.744	0.009	2.863	1.294~6.333
CESEI得分	-0.062	0.028	4.873	0.027	0.940	0.889~0.993

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