老年心力衰竭患者症状感知、健康素养对院前就医延迟的影响

摘要/Abstract

摘要： 目的了解老年心力衰竭患者症状感知、健康素养对就医延迟的影响。方法便利选取180例2022年10月—2023年10月在无锡某三甲医院就诊的老年心力衰竭患者为研究对象,采用一般资料问卷、心力衰竭症状感知量表、健康素养量表对患者进行调查。采用二元Logistic回归分析就医延迟的独立影响因素。结果共成功回收167份问卷,患者就医时间为7（2,9）d,最短就医时间0 d,最长就医时间17 d,91例（54.5%）患者就医延迟。二元Logistic回归分析显示,胸部不适（B=-0.285,OR=0.752,P=0.021）、呼吸困难（B=-0.107,OR=0.898,P=0.024）、早期轻微症状（B=0.131,OR=1.140,P=0.026）、健康素养（B=-0.078,OR=0.925,P=0.006）为患者就医延迟的独立影响因素。结论老年心力衰竭患者就医延迟现况亟待改善,医护人员应优化健康教育模式以改善患者症状感知和健康素养水平,缩短就医时间,改善预后。

关键词: 心力衰竭, 就医延迟, 症状感知, 健康素养, 老年

中图分类号:

R541

胡尧尧, 朱凌云, 周苔花, 李晓静, 陈潇潇, 李俐. 老年心力衰竭患者症状感知、健康素养对院前就医延迟的影响[J]. 承德医学院学报, 2025, 42(5): 403-407.

导出引用管理器 EndNote|Ris|BibTeX

链接本文: http://tougao.cdmc.edu.cn:8088/CN/

http://tougao.cdmc.edu.cn:8088/CN/Y2025/V42/I5/403

参考文献

[1] Ponikowski P, Anker SD, AlHabib KF, et al. Heart failure: preventing disease and death worldwide[J]. ESC Heart Fail, 2014, 1(1): 4-25.
[2] Guang Hao, Wang Xin, Chen Zuo, et al.Prevalence of heart failure and left ventricular dysfunction in China: the China Hypertension Survey, 2012-2015[J]. Eur J Heart Fail, 2019, 21(11): 1329-1337.
[3] 徐梦琦,龚静欢,罗桢蓝,等. 心力衰竭患者就医延迟的研究进展[J]. 护理学杂志,2021,36(16):95-98.
[4] Lin CY, Hammash M, Miller JL, et al.Delay in seeking medical care for worsening heart failure symptoms: predictors and association with cardiac events[J]. Eur J Cardiovasc Nurs, 2021, 20(5): 454-463.
[5] 王飞宇,刘晓梅,惠蓉. 基于症状管理理论的急性心力衰竭患者延迟就医影响因素分析[J]. 新疆医科大学学报,2019,42(12):1640-1644,1649.
[6] 邢龙,易银萍,陶琳,等. 心力衰竭病人症状感知过程及干预的研究进展[J]. 全科护理,2022,20(29):4072-4075.
[7] Magnani JW, Mujahid MS, Aronow HD, et al.Health Literacy and Cardiovascular Disease: Fundamental Relevance to Primary and Secondary Prevention: A Scientific Statement From the American Heart Association[J]. Circulation, 2018, 138(2): e48-e74.
[8] Schliemann D, Ismail R, Donnelly M, et al.Anticipated delay in help-seeking for cancer symptoms: Findings from a nationwide study of Malaysian adults[J]. Cancer Epidemiol, 2021, 71(Pt A): 101882.
[9] 江淀淀,崔妙玲,黄维,等. 肺癌患者就医延迟风险预测模型的构建及验证[J]. 中华护理杂志,2023,58(6):682-688.
[10] 万霞,刘建平. 临床研究中的样本量估算:(2)观察性研究[J]. 中医杂志,2007,48(7):599-601.
[11] Corrine-Y Jurgens, Lee Christopher-S, Riegel Barbara.Psychometric Analysis of the Heart Failure Somatic Perception Scale as a Measure of Patient Symptom Perception[J]. J Cardiovasc Nurs, 2017, 32(2): 140-147.
[12] 朱旭霄. HFSPS心衰躯体感知量表的汉化及初步应用[D]. 湖州:湖州师范学院,2018.
[13] Shiho Matsuoka, Kato Naoko, Kayane Takahiro, et al.Development and Validation of a Heart Failure-Specific Health Literacy Scale.[J]. J Cardiovasc Nurs, 2016, 31(2): 131-139.
[14] 张艳杰,杨巧芳. 郑州市老年慢性心力衰竭患者的健康素养现况及影响因素分析[J]. 职业与健康,2020,36(17):2384-2390.
[15] Xu M, Ruan T, Huang X, et al.Care-seeking delay of patients with heart failure in China: a mixed-method study[J]. ESC Heart Fail, 2024, 11(4): 2086-2099.
[16] 李少玲,卢晓虹,魏丽丽,等. 心力衰竭患者延迟就医原因的质性研究[J]. 中华现代护理杂志,2021,27(24):3234-3238.
[17] Okada A, Tsuchihashi-Makaya M, Kang J, et al.Symptom Perception, Evaluation, Response to Symptom, and Delayed Care Seeking in Patients With Acute Heart Failure: An Observational Study[J]. J Cardiovasc Nurs, 2019, 34(1): 36-43.
[18] Reeder KM, Peek GM, Nazir N. Prehospitalization Symptom Perceptions, Lay Consultations,Treatment-Seeking for Acute Decompensating Heart Failure: Implications for Nursing Practice[J]. Crit Care Nurs Clin North Am, 2022, 34(2): 129-140.
[19] Hagger MS, Orbell S.The common sense model of illness self-regulation: a conceptual review and proposed extended model[J]. Health Psychol Rev, 2022, 16(3): 347-377.
[20] Riegel B, De Maria M, Barbaranelli C, et al.Symptom Recognition as a Mediator in the Self-Care of Chronic Illness[J]. Front Public Health, 2022, (10): 883299.
[21] 龚静欢,朱凌燕,罗桢蓝,等. 心力衰竭患者症状管理体验的质性研究[J]. 护理学杂志,2021,36(12):39-42.
[22] 玉洁. 健康素养对慢性病患病的影响[J]. 中国慢性病预防与控制,2017,25(6):442-444.
[23] Fan ZY, Yang Y, Yin RY, et al.Effect of Health Literacy on Decision Delay in Patients With Acute Myocardial Infarction[J]. Front Cardiovasc Med, 2021, (8): 754321.
[24] Garrido D, Petrova D, Catena A, et al.Recognizing a Heart Attack: Patients' Knowledge of Cardiovascular Risk Factors and Its Relation to Prehospital Decision Delay in Acute Coronary Syndrome[J]. Front Psychol, 2020, (11): 2056.
[25] Fabbri M, Murad MH, Wennberg AM, et al.Health Literacy and Outcomes Among Patients With Heart Failure: A Systematic Review and Meta-Analysis[J]. JACC Heart Fail, 2020, 8(6): 451-460.