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聚类分析:一种识别生活质量差风险的老年心脏病患者的有用技术。

Cluster analysis: a useful technique to identify elderly cardiac patients at risk for poor quality of life.

作者信息

Fukuoka Yoshimi, Lindgren Teri G, Rankin Sally H, Cooper Bruce A, Carroll Diane L

机构信息

School of Nursing, University of California San Francisco, San Francisco, CA 94143, USA.

出版信息

Qual Life Res. 2007 Dec;16(10):1655-63. doi: 10.1007/s11136-007-9272-7. Epub 2007 Oct 23.

Abstract

OBJECTIVE

The purposes of this study are (1) to examine the frequency of cardiac symptoms in elderly people one year after acute myocardial infarction (AMI) and/or coronary artery bypass surgery (CABG); (2) to identify patient subgroups (cluster solutions) based on cardiac symptoms after cardiac events and (3) to determine if these subgroups vary based on health related quality of life and psychological distress.

METHODS

A sample of 206 elderly, unpartnered, patients (age > or = 65) were interviewed one year after AMI and/or CABG by telephone. Cardiac symptoms, SF-36, POMS, and QOL-I were measured. A hierarchical cluster analysis was used to identify patient subgroups based on cardiac symptoms, using a combination of dendrograms and stopping rules.

RESULTS

Three subgroups were identified: (1) the Weary (19.4%), (2) the Diffuse symptom (68.4%), and (3) the Breathless groups (12.2%). The Weary group had significantly lower scores on all of SF-36 subscales (except for social functioning) and higher scores on all of POMS subscales (except for Anger/hostility and Confusion/Bewilderment) compared to the Diffuse symptom group.

CONCLUSIONS

The cluster analysis was useful to identify the subgroup with poorer recovery. Patients in the Weary group need more attention and intervention strategies to improve their health.

摘要

目的

本研究的目的是:(1)检查老年人在急性心肌梗死(AMI)和/或冠状动脉搭桥手术(CABG)一年后的心脏症状发生频率;(2)根据心脏事件后的心脏症状确定患者亚组(聚类解决方案);(3)确定这些亚组在健康相关生活质量和心理困扰方面是否存在差异。

方法

对206名年龄≥65岁的老年单身患者在AMI和/或CABG一年后进行电话访谈。测量心脏症状、SF-36、POMS和QOL-I。采用分层聚类分析,结合树形图和停止规则,根据心脏症状确定患者亚组。

结果

确定了三个亚组:(1)疲惫组(19.4%),(2)弥漫性症状组(68.4%),(3)气短组(12.2%)。与弥漫性症状组相比,疲惫组在所有SF-36子量表(社会功能除外)上得分显著更低,在所有POMS子量表(愤怒/敌意和困惑/迷茫除外)上得分更高。

结论

聚类分析有助于识别恢复较差的亚组。疲惫组患者需要更多关注和干预策略以改善其健康状况。

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