Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio (Ms Frank); and Department of Exercise Science, Bloomsburg University of Pennsylvania, Bloomsburg, USA.
J Cardiopulm Rehabil Prev. 2011 Jul-Aug;31(4):223-9. doi: 10.1097/HCR.0b013e31820333b3.
This is a retrospective and descriptive analysis of demographic and clinical factors common among cardiac rehabilitation patients with high versus low perceptions of health-related quality of life(HRQOL). In addition, we describe the characteristics that are predictive of greater improvements in HRQOL during cardiac rehabilitation.
We included 970 patients (63.6 10.6 years; 71% male patients) referred to a 12-week program between 1996 and 2006 who all completed a HRQOL questionnaire at baseline and program completion.Patients were divided into 4 quartiles based on HRQOL scores at program entry. The Kruskall-Wallis test and χ² analyses determined differences between quartiles for continuous and categorical variables,respectively. In addition, regression models predicted changes in HRQOL during the course of the cardiac rehabilitation program.
At program entry, quartile differences were found for diagnosis (P = .04), number of risk factors (P < .01), self-efficacy (P < .001), and caloric expenditure (P = .05). Significant predictors of change included baseline HRQOL sores, flexibility, and left ventricular ejection fraction (R² = 0.50; P = .001).
The factors found that related to baseline HRQOL and were predictive of the change in HRQOL were primarily clinical and functional in nature. This suggests that those who have greater physical functionality, the confidence to perform physical tasks, and are not limited clinically, may more readily adapt to cardiac rehabilitation and progress more rapidly. Those patients with the poorest exercise capacities at entrance to the program tended to make the greatest gains in HRQOL.
本研究回顾并描述了心脏康复患者中，健康相关生活质量（HRQOL）感知高低两组人群的人口统计学和临床特征。此外，我们还描述了在心脏康复过程中，预测 HRQOL 得到更大改善的特征。
我们纳入了 970 名（63.6±10.6 岁；71%为男性）于 1996 年至 2006 年期间被推荐参加为期 12 周的心脏康复计划的患者，所有患者在入组时和项目结束时均完成了 HRQOL 问卷。患者根据入组时的 HRQOL 评分分为 4 个四分位组。Kruskal-Wallis 检验和 χ²分析分别确定了连续和分类变量在四分位组之间的差异。此外，回归模型预测了心脏康复项目期间 HRQOL 的变化。
在项目入组时，我们发现四分位组之间在诊断（P=0.04）、危险因素数量（P＜0.01）、自我效能（P＜0.001）和热量消耗（P=0.05）方面存在差异。变化的显著预测因素包括基线 HRQOL 评分、灵活性和左心室射血分数（R²=0.50；P=0.001）。
与基线 HRQOL 相关且预测 HRQOL 变化的因素主要是临床和功能性质的。这表明，那些具有更高的身体功能、执行身体任务的信心且临床受限较小的患者可能更容易适应心脏康复并更快地取得进展。那些在进入项目时运动能力最差的患者在 HRQOL 方面往往会取得最大的改善。
