中青年冠心病患者支架植入术后自我感受负担影响因素研究

发布时间：2018-12-06 17:17

【摘要】：目的:通过半结构式访谈和问卷调查探讨中青年冠脉支架植入术后患者自我感受负担的影响因素,为降低患者自我感受负担,促进疾病恢复,同时也为医护工作者能进行针对性的干预提供参考依据。方法:本研究分为两个部分。自2016年3月至2017年1月,选择在江西省南昌市两所综合性三级甲等医院心内科住院部及门诊复查的中青年冠脉支架植入术后患者作为研究对象。第一部分,使用质性研究现象学法,制定访谈大纲,对12名患者进行半结构式访问。访谈资料采用Colaizzi分析法进行归纳、分析,最后提炼出主题,描述他们由于自身疾病而产生的SPB状况的体验。第二部分,运用一般资料问卷、自我感受负担量表、综合医院焦虑抑郁量表及简易健康状况调查问卷评估153名患者的一般情况、自我感受负担、焦虑抑郁和生活质量现状。采用SPSS17.0统计软件对数据进行统计分析,本研究中应用的方法有描述性分析、t检验、单因素方差分析、Pearson相关性分析及多元线性逐步回归分析。结果:第一部分:将质性访谈后收集的资料提炼出5个主题:疾病因素,经济负担,心理内疚感过重,缺乏疾病相关康复知识,未能实现自我价值。第二部分:问卷调查结果中青年冠脉支架植入术后患者自我感受负担总分为32.15±8.96分。其包含的身体负担、情感负担、经济负担维度得分分别是5.35±1.90分、19.51±5.58分和7.26±8.96分。其中,一般资料单因素分析显示,患者的不同年龄段、目前工作状态、家庭月收入、支架植入数目、对病情了解程度及合并症等对自我感受负担影响有统计学意义(P0.05);相关性分析提示患者自我感受负担与焦虑抑郁呈正相关,与生活质量呈负相关;多元线性逐步回归分析结果显示:生活质量、抑郁、目前工作状态(继续工作)、对疾病了解程度和家庭月收入是中青年冠脉支架植入患者自我感受负担的重要影响因素。结论:1.中青年冠脉支架植入术后患者的自我感受负担大部分处于中度及以上程度。2.中青年冠脉支架植入术后患者的焦虑抑郁发生率较高,与患者自我感受负担呈正相关;患者的生活质量水平较低,与其自我感受负担呈负相关。3.患者生活质量水平、抑郁状态、目前工作状态(继续工作)、对疾病了解程度和家庭月收入是中青年冠脉支架植入术后患者自我感受负担的重要影响因素。4.通过质性和量性研究相结合的方法更全面的探讨中青年冠脉支架植入术后患者自我感受负担的影响因素,可以对单一质性研究和量性研究的缺点进行互补。
[Abstract]:Objective: to explore the influencing factors of the self-feeling burden of young and middle-aged patients after coronary stent implantation through semi-structured interviews and questionnaires, in order to reduce the burden of self-perception and promote the recovery of disease. At the same time, it also provides reference for health care workers to carry out targeted intervention. Methods: this study was divided into two parts. From March 2016 to January 2017, young and middle-aged patients undergoing coronary stent implantation in two comprehensive Grade 3A hospitals in Jiangxi Province were selected as subjects. In the first part, using the phenomenological method of qualitative research, the interview syllabus was developed and 12 patients were interviewed in a semi-structured way. The interview data were summarized and analyzed by Colaizzi method. Finally, the theme was extracted to describe the experience of SPB status caused by their own disease. In the second part, 153 patients were assessed with general information questionnaire, self-perceived burden scale, general hospital anxiety and depression scale and simple health status questionnaire. The methods used in this study are descriptive analysis, t test, single factor variance analysis, Pearson correlation analysis and multiple linear stepwise regression analysis. Results: in the first part, the data collected after qualitative interview were abstracted into five themes: disease factors, economic burden, excessive psychological guilt, lack of rehabilitation knowledge related to disease, and failure to realize self-worth. Part two: the total score of self-feeling burden of young patients after coronary stent implantation was 32.15 卤8.96. The scores of physical burden, emotional burden and economic burden were 5.35 卤1.90, 19.51 卤5.58 and 7.26 卤8.96 respectively. Single factor analysis of general data showed that the patients' different age, current working status, family monthly income, the number of stent implantation, the degree of understanding of the disease and complications had a significant impact on the burden of self-perception (P0.05). Correlation analysis showed that the self-perceived burden was positively correlated with anxiety and depression, and negatively correlated with quality of life. The results of multiple linear stepwise regression analysis showed that quality of life, depression, current working status, understanding degree of disease and monthly income of family were the important factors influencing self-feeling burden of young and middle-aged patients with coronary stent implantation. Conclusion: 1. The burden of self-perception of young and middle-aged patients after coronary stent implantation was mostly in the moderate and above degree. 2. 2. The incidence of anxiety and depression was higher in young and middle-aged patients after coronary stent implantation, which was positively correlated with the burden of self-feeling, and the quality of life was lower, which was negatively correlated with the burden of self-perception. The quality of life (QOL), depression, current working status (continue to work), the degree of understanding of disease and monthly family income are the important factors that affect the burden of self-feeling after coronary stent implantation in young and middle-aged patients. 4. Through the combination of qualitative and quantitative studies, the factors affecting the self-perception burden of young and middle-aged patients after coronary stent implantation are discussed more comprehensively, which can complement the shortcomings of single qualitative research and quantitative research.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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