成人心脏外科术后居家患者疲劳现状及影响因素分析

doi:10.3969/j.issn.1006-5725.2024.24.018

Abstract

Abstract:

Objective This study aimed to explore the current status of home-based fatigue among patients after cardiac surgery and analyze its influencing factors. Methods From January 2023 to December 2023， we retrospectively collected data from 200 patients who underwent cardiac surgery and were discharged for more than 3 months from Guangdong Provincial People's Hospital. The Multidimensional Fatigue Inventory-20， Overall Pain Assessment Scale， Cardiac Rehabilitation Inventory and Self-efficacy for Managing Chronic Disease 6-Item Scale were used to assess the patients. Results Overall fatigue of patients at home after cardiac surgery was at a moderate level. A stepwise multiple linear regression analysis revealed that anxiety during cardiac rehabilitation （β = 7.476， P = 0.001）， severe pain （β = 11.939， P = 0.001）， and frequency of discomfort symptoms （P < 0.001） significantly positively predicted post-cardiac surgery fatigue， whereas self-efficacy in chronic disease management （β = -6.974， P < 0.001） significantly negatively predicted it. Conclusions Fatigue among home-based patients after cardiac surgery requires further improvement and is associated with cardiac rehabilitation anxiety， pain severity， self-efficacy， and frequency of discomfort symptoms. Healthcare providers could develop targeted continuity interventions based on these influencing factors to reduce fatigue levels and promote recovery among home-based patients after cardiac surgery.

Key words: heart surgery, fatigue, pain, self-efficacy, influencing factor

CLC Number:

R473.5

Yuan LIU,Jing LAI,Danying MA,Lingzi WU,Wei. WANG. Analysis of fatigue status and influencing factors of adult patients at home after cardiac surgery[J]. The Journal of Practical Medicine, 2024, 40(24): 3547-3553.

Figures/Tables 6

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Tab.5

References 33

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变量	得分	变量	得分
多维疲劳量表总分	51.35 ± 14.28	疼痛与日常行为能力均分	1.82 ± 2.37
体力疲劳维度	26.59 ± 8.28	整体疼痛评估量表总分均分	2.13 ± 2.19
脑力疲劳维度	9.42 ± 3.55	管理慢性病6项量表总分均分	7.07 ± 2.06
动力下降维度	6.79 ± 2.27	症状管理自我效能	6.97 ± 2.16
活动减少维度	8.56 ± 2.90	疾病共性管理自我效能	7.26 ± 2.20
整体疼痛评估量表总分	42.60 ± 43.75	心脏康复过程焦虑	13.92 ± 4.20
疼痛维度均分	2.01 ± 2.05	心脏康复结果焦虑	8.28 ± 3.07
疼痛的情绪感受均分	2.33 ± 2.85	心脏康复自主性	17.36 ± 2.787
疼痛的临床表现均分	2.35 ± 2.64

变量	例（%）	得分	t/F值	P值
重返工作岗位			33.344	< 0.001
已重返	86（43.0）	48.73 ± 15.09
临时工作	19（9.5）	49.89 ± 13.03
未重返	95（47.5）	54.02 ± 13.40
焦虑			18.260	< 0.001
无过程焦虑	168（84.0）	48.99 ± 12.86
有过程焦虑	32（16.0）	63.75 ± 15.17
无结果焦虑	138（69.0）	48.58 ± 13.88
有结果焦虑	62（31.0）	57.53 ± 13.29
慢性病自我效能			27.516	< 0.001
自我效能低水平	17（8.5）	64.53 ± 12.90
自我效能中水平	110（55.0）	54.65 ± 10.96
自我效能高水平	73（36.5）	43.32 ± 14.90
疼痛分级			18.520	< 0.001
无痛	87（43.5）	45.00 ± 14.25
轻度疼痛	89（44.5）	53.96 ± 11.84
中度疼痛	14（7.0）	60.71 ± 8.14
重度疼痛	10（5.0）	70.40 ± 10.49
是否服用止疼药物			2.888	0.007
是	21（10.5）	57.52 ± 9.73
否	179（89.5）	50.63 ± 14.58
是否睡眠不佳			15.900	< 0.001
是	71（35.5）	48.47 ± 14.51
否	129（64.5）	56.59 ± 12.34
是否伤口疼痛			3.413	0.001
是	55（27.5）	56.22 ± 11.33
否	145（72.5）	49.51 ± 14.88
是否感到心悸			4.094	< 0.001
是	65（32.5）	57.09 ± 13.22
否	135（67.5）	48.59 ± 14.00
是否感到气喘、气促			3.770	< 0.001
是	171（85.5）	60.31 ± 11.25
否	29（14.5）	49.84 ± 14.21
出现不适症状的频率			16.659	< 0.001
几乎每天	44（22.0）	59.61 ± 13.03
每周3 ~ 4次	28（14.0）	57.29 ± 9.43
每周1次	37（18.5）	53.70 ± 10.51
每月1次	21（10.5）	53.10 ± 8.32
几乎没有	70（35.0）	42.03 ± 14.85

变量	赋值
心脏康复过程焦虑	是=1，否=0
心脏康复结果焦虑	是=1，否=0
心悸	是=1，否=0
睡眠不佳	是=1，否=0
自我效能分级	自我效能_中（是=1，否=0）；自我效能_高（是=1，否=0）
疼痛分级	疼痛分级_轻度（是=1，否=0）；疼痛分级_中度（是=1，否=0）；疼痛分级_重度（是=1，否=0）
不适症状频率	不适症状_每月1次（是=1，否=0）；不适症状_每周1次（是=1，否=0）；不适症状_每周3 ~ 4次（是=1，否=0）；不适症状_几乎每天（是=1，否=0）

变量	β	SE	标准化回归系数	t值	P值	95%CI
常数	51.244	3.017		16.986	< 0.001	45.293 ~ 57.195
康复结果焦虑	3.531	1.786	0.115	1.977	0.050	0.007 ~ 7.054
康复过程焦虑	7.476	2.290	0.192	3.265	0.001	2.959 ~ 11.992
疼痛_重度	11.939	3.601	0.183	3.315	0.001	4.835 ~ 19.042
自我效能_中	-7.665	2.790	-0.268	-2.747	0.007	-13.168 ~ -2.161
自我效能_高	-14.543	2.976	-0.491	-4.887	< 0.001	-20.413 ~ -8.673
不适症状_每月1次	8.658	2.689	0.186	3.220	0.002	3.355 ~ 13.962
不适症状_每周1次	9.631	2.173	0.262	4.433	< 0.001	5.345 ~ 13.917
不适症状_每周3 ~ 4次	12.600	2.396	0.307	5.259	< 0.001	7.874 ~ 17.326
不适症状_几乎每天	10.419	2.207	0.303	4.720	< 0.001	6.065 ~ 14.773

变量	β	SE	标准化回归系数	t值	P值	95%CI
常数	42.155	1.460		28.882	< 0.001	39.276 ~ 45.033
心悸	5.273	1.922	0.173	2.744	0.007	1.483 ~ 9.064
睡眠不佳	5.653	1.842	0.190	3.069	0.002	2.021 ~ 9.286
疼痛_轻度	7.516	1.883	0.262	3.991	< 0.001	3.802 ~ 11.231
疼痛_中度	15.411	3.507	0.276	4.394	< 0.001	8.494 ~ 22.328
疼痛_重度	21.124	4.180	0.323	5.053	< 0.001	12.880 ~ 29.369

Analysis of fatigue status and influencing factors of adult patients at home after cardiac surgery

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