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心房颤动患者的症状、疾病接受度及健康相关生活质量

Symptoms, acceptance of illness and health-related quality of life in patients with atrial fibrillation.

作者信息

Jankowska-Polańska Beata, Kaczan Aleksandra, Lomper Katarzyna, Nowakowski Dariusz, Dudek Krzysztof

机构信息

1 Department of Clinical Nursing, Wroclaw Medical University, Poland.

2 Department of Clinical Nursing, Student Scientific, Wroclaw Medical University, Poland.

出版信息

Eur J Cardiovasc Nurs. 2018 Mar;17(3):262-272. doi: 10.1177/1474515117733731. Epub 2017 Sep 21.

Abstract

INTRODUCTION

Acceptance of illness plays a key role, allowing the patient to adapt to the disease and its treatment, and to maintain their health-related quality of life (HRQOL) despite chronic conditions.

AIM

The aim of the study was to assess the relationship between severity of arrhythmia symptoms, acceptance of illness and HRQOL in patients with atrial fibrillation.

METHODS

The study included 99 patients (mean age 64.6) treated for atrial fibrillation. Three standardized instruments were used: the World Health Organization Quality of Life (WHOQoL-BREF) questionnaire, the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia (ASTA) and the Acceptance of Illness Scale (AIS).

RESULTS

Patients with high illness acceptance levels obtained better results in all WHOQoL-BREF domains: physical (57.0±8.9 vs. 51.1±12.5 vs. 42.0±6.2; p<0.001), social (62.6±19.8 vs. 52.5±20.0 vs. 45.7±16.0; p=0.019) and environmental (62.9±12.7 vs. 52.7±7.6 vs. 60.7±3.6; p<0.001), and in the ASTA HRQOL scale (10.5±5.4 vs. 16.1±7.6 vs. 20.3±0.5; p<0.001). Multiple-factor analysis showed AIS to be a statistically significant independent determinant of HRQOL in the physical domain of the WHOQoL (β=0.242) and in the overall HRQOL assessment in the ASTA HRQOL scale (β= -0.362). Other statistically significant independent predictors included: the negative impact of female sex on the physical (β= -0.291) and social (β= -0.284) domains of the WHOQOL-BREF, and the positive impact of urban residence on the physical WHOQOL-BREF domain and on symptom intensity in the ASTA symptom scale.

CONCLUSIONS

Acceptance of illness is an important factor which has been shown to impact on HRQOL in atrial fibrillation. Female sex is a predictor of worse HRQOL, while urban residence improves HRQOL in the physical domain and decreases symptom intensity (ASTA symptom scale).

摘要

引言

对疾病的接受程度起着关键作用,它能使患者适应疾病及其治疗,并在患有慢性病的情况下维持其健康相关生活质量(HRQOL)。

目的

本研究旨在评估房颤患者心律失常症状的严重程度、对疾病的接受程度与HRQOL之间的关系。

方法

该研究纳入了99例接受房颤治疗的患者(平均年龄64.6岁)。使用了三种标准化工具:世界卫生组织生活质量(WHOQoL-BREF)问卷、心动过速和心律失常特异性问卷(ASTA)以及疾病接受量表(AIS)。

结果

疾病接受程度高的患者在WHOQoL-BREF的所有领域均取得了更好的结果:生理领域(57.0±8.9对51.1±12.5对42.0±6.2;p<0.001)、社会领域(62.6±19.8对52.5±20.0对45.7±16.0;p=0.019)和环境领域(62.9±12.7对52.7±7.6对60.7±3.6;p<0.001),以及在ASTA HRQOL量表中(10.5±5.4对16.1±7.6对20.3±0.5;p<0.001)。多因素分析显示,AIS是WHOQoL生理领域HRQOL(β=0.242)以及ASTA HRQOL量表总体HRQOL评估中具有统计学意义的独立决定因素(β= -0.362)。其他具有统计学意义的独立预测因素包括:女性性别对WHOQoL-BREF生理领域(β= -0.291)和社会领域(β= -0.284)的负面影响,以及城市居住对WHOQoL-BREF生理领域和ASTA症状量表中症状强度的正面影响。

结论

对疾病的接受程度是一个重要因素,已证明其会影响房颤患者的HRQOL。女性性别是HRQOL较差的一个预测因素,而城市居住可改善生理领域的HRQOL并降低症状强度(ASTA症状量表)。

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