冠心病患者自我管理行为潜在剖面及其影响因素分析

目的 探讨冠心病患者自我管理行为的潜在分类，并分析不同类别的影响因素。方法 采用便利抽样的方法于2021年8月—2021年11月对郑州市某三级甲等医院心内科750名患者进行调查。调查内容包括一般资料、冠心病相关知识评价调查表、Champion健康信念模型量表和冠心病自我管理行为量表。采用Mplus 7.4对冠心病患者自我管理行为进行潜在剖面分析，并通过logistic回归分析潜在分类的影响因素。结果 本研究共纳入716例研究对象，平均年龄为（63.32±9.86）岁。最终识别出三个自我管理行为的潜在类别，分别为“自我管理行为较好-情绪调节无效型”（33%，n = 236）、“自我管理行为中等-急救管理缺乏型”（35%，n = 251）和“自我管理行为较差-依从管理不良型”（32%，n = 229）。Logistic回归分析得到年龄较大（OR = 2.610，95%CI:1.930～3.529）和心功能较差（OR = 2.450，95%CI:1.616～3.714）是自我管理行为的危险因素，有配偶（OR = 0.987，95%CI:0.769～.998）、受教育时间较长（OR = 0.697，95%CI:0.311～0.958）、家庭月收入较高（OR = 0.511，95%CI:0.176～0.883）、PSK - CHD得分较高（OR = 0.210，95%CI:0.089～0.497）和CHBMS得分较高（OR = 0.971，0.363～0.997）是自我管理行为的保护因素。结论 本研究确定了冠心病患者自我管理行为的三种潜在分类和预测因素，这为医务人员制定针对性的临床干预措施提供依据。

Analysis of potential profiles of self-management behaviors and their influencing factors in patients with coronary artery disease

Objective To explore the potential classification of self-management behaviors in patients with coronary heart disease and to analyze the influencing factors of different categories. Methods A convenience sampling method was used to survey 750 patients in the cardiology department of a tertiary care hospital in Zhengzhou from August 2021 to November 2021. The survey included general information, coronary heart disease-related knowledge evaluation questionnaire, Champion Health Belief Model Scale and Coronary Heart Disease Self-Management Behavior Scale. Mplus 7.4 was used to analyze the potential profiles of self-management behaviors of patients with coronary heart disease, and the factors influencing the potential classification were analyzed by logistic regression. Results A total of 716 participants with a mean age of 63.32±9.86 years were included in this study. Three potential categories of self-management behaviors were finally identified: “good self-management behavior-ineffective emotion regulation” (33%, n=236), “moderate self-management behavior-lack of first aid management” (35%, n=251), and “poor self-management behavior-poor compliance management type” (32%, n=229). Logistic regression analysis showed that older age (OR=2.610, 1.930 to 3.529) and poor cardiac function (OR=2.450, 1.616 to 3.714) were self-management behavior risk factors, while spouse(OR=0.987, 0.769 to 0.998), longer education duration (OR=0.697, 0.311 to 0.958), higher monthly household income (OR=0.511, 0.176 to 0.883), higher PSK-CHD scores (OR=0.210, 0.089 to 0.497) and CHBMS scores (OR=0.971, 0.363 to 0.997) were protective factors for self-management behaviors. Conclusion This study identifies three potential classifications and predictors of self-management behaviors in patients with coronary heart disease, which provides a basis for medical professionals to develop targeted clinical interventions.