出院过渡期老年心力衰竭患者相关症状及影响因素的纵向研究

目的调查老年心力衰竭患者出院过渡期心衰相关症状,分析其变化趋势及影响因素。方法采用Memorial心力衰竭症状评估量表、心脏病患者抑郁量表、照护负担问卷和家属照护者照护能力问卷,对219例老年心衰患者及主要家庭照护者,于患者出院前1～2 d、出院后1个月和3个月进行调查。结果患者的心衰相关症状随着出院过渡期的延长呈恶化趋势,与出院前1～2 d相比,出院后1个月和3个月患者的心衰症状总分及各维度得分显著提高(P<0.01)。抑郁症状在出院后1个月得分最高(90.31±3.27),随着过渡时间的延长得分逐渐下降(P<0.01)。回归分析显示,出院过渡期患者心衰相关症状受患者服药种类、心功能分级和照护能力的影响;抑郁受患者年龄、病程和住院次数的影响(P<0.05,P<0.01)。结论老年心衰患者出院过渡期心衰相关症状较差且呈动态变化,受多种因素影响。护理人员应该制定针对性的过渡期护理计划,减轻患者症状负担。

Symptoms of elderly heart failure patients during transitions from hospital to home and the influencing factors:a longitudinal study

Objective To investigate the symptoms of elderly heart failure patients during the transition from hospital to home,and to analyze the change trends and influencing factors. Methods A total of 219 elderly heart failure patients and their family caregivers were investigated using the Memorial Symptom Assessment Scale for Heart Failure (MSAS-HF), Cardiac Depression Scale (CDS), Zarit Burden Interview (ZBI) and the Family Caregiver Task Inventory ( FCTI) at 1-2 d before discharge, 1 and 3 months after discharge. Results The symptoms of heart failure were aggravated during the transitional period. Compared with the baseline values at 1-2d before discharge, the total MS AS-HF score and dimension scores were significantly increased at 1 and 3 months after discharge (P<0.01). The score of depression was highest at 1 month after discharge.being 90.31±3.27, and then it was decreased(P<0.01)). Regression analysis indicated that heart failure symptoms were affected by the number of medications used per day, cardiac function grading and caregiving ability of the family caregivers;and depression was predicted by age, course of disease and counts of hospitalization (P<0.05,P<0.01). Conclusion Elderly heart failure patients had worse symptoms that were changed dynamically and affected by many factors during the transitional period, so nurses should conduct targeted transitional care to ameliorate their symptom burden.