急性心肌梗死患者疲劳发展轨迹的调查研究

目的 探讨急性心肌梗死（acute myocardial infarction,AMI）患者疲劳发展轨迹及影响因素。方法 2019年12月—2021年1月,采用方便抽样法,选取湖州市某三级甲等医院心内科首次发生AMI的206例患者作为调整对象。采用多维疲劳量表在患者入院后第2天、出院后1个月、2个月、4个月调查患者的疲劳水平,采用潜类别增长模型及单因素分析进行数据处理。结果 识别出AMI患者疲劳轨迹分为3个潜在类别,分别为明显改善组（15.2%）、缓慢缓解组（62.8%）、持续疲劳组（22.0%）;不同轨迹类别在性别（χ²=29.384,P<0.001）、婚姻状况（χ²=6.774,P=0.034）、共病个数（χ²=27.131,P<0.001）和心功能分级（χ²=20.416,P<0.001）方面,差异有统计学意义。结论 AMI患者从急性入院至出院后4个月内,大部分患者的疲劳能得到良好的改善,其疲劳轨迹存在群体异质性,护士应根据疲劳变化轨迹及其影响因素,给予患者阶段性及特异性的护理干预。

The investigation of fatigue development trajectory in patients with acute myocardial infarction

Objective To explore the fatigue development trajectory and influencing factors of postoperative patients with acute myocardial infarction（AMI）. Methods From December 2019 to January 2021,206 patients with first AMI in the cardiology department of a tertiary hospital in Huzhou were selected by convenience sampling method. The multidimensional fatigue scale-20 was used to investigate the patient’s fatigue level on the second day after admission and 1,2,4 months after discharge,and the latent class growth model and single factor analysis were used for data processing. Results It is recognized that the fatigue trajectory of AMI patients is divided into 3 potential categories,namely,the obvious improvement group（15.2%）,the slow remission group（62.8%）,and the continuous fatigue group（22.0%）;single factor analysis shows that the 3 trajectory categories are different with statistical significance in gender （χ²=29.384,P<0.001）,marital status （χ²=6.774,P=0.034）,number of comorbidi-ties（χ²=27.131,P<0.001） and cardiac function classification（χ²=20.416,P<0.001）. Conclusion The fatigue of most patients with AMI can be improved within 4 months from acute admission to discharge. There is group heterogeneity in fatigue trajectory. Medical staff should formulate staged and specific full-course nursing interventions according to different trajectory categories.