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心肌梗死后随访患者左心室收缩功能与自我保健及相关因素的关系。

Self-care and related factors associated with left ventricular systolic function in patients under follow-up after myocardial infarction.

机构信息

Stroke Unit, Hanyng University Seoul Hospital, South Korea.

College of Nursing, Hanyang University, South Korea.

出版信息

Eur J Cardiovasc Nurs. 2021 Jan 1;20(1):5-13. doi: 10.1177/1474515120923201.

Abstract

BACKGROUND

Recent advances in treatment have led to long-term survival after myocardial infarction (MI), but subsequent complications such as heart failure have also increased, and, therefore, the relationship between prognosis and self-care needs to be investigated.

AIMS

This study aimed to confirm the relationship of potential variables affecting self-care of patients after MI and to determine whether self-care predicts left ventricular systolic function.

METHODS

Using a descriptive study design, a hypothetical model was constructed based on previous studies, and 191 post-MI patients were recruited from three university hospital outpatient clinics in Korea. The modified model was verified by constructing a structural equation model using AMOS version 24.0. The exogenous variables were illness perception, social support, and depression symptoms. The endogenous variables were self-efficacy, self-care compliance, and changes in left ventricular ejection fraction (LVEF).

RESULTS

The average patient age and disease duration were 66.3 (±11.5) years and 62.1 (±56.6) months, respectively. Self-care compliance was directly influenced by self-efficacy and indirectly affected by social support. Self-care compliance had a direct effect on LVEF changes, which was indirectly associated with illness perception, social support, and self-efficacy.

CONCLUSION

This study confirmed the direct effect of self-care compliance on changes in LVEF in patients under follow-up after MI. It is necessary to periodically monitor the degree of self-care in outpatients who are undergoing follow-up after MI to prevent a decrease in cardiac function. Counseling and education may be effective forms of social support to improve disease awareness and self-efficacy among patients with low self-care compliance.

摘要

背景

心肌梗死(MI)后的治疗进展导致了长期生存,但随后的并发症,如心力衰竭,也有所增加,因此需要研究预后与自我护理之间的关系。

目的

本研究旨在确认影响 MI 后患者自我护理的潜在变量之间的关系,并确定自我护理是否可以预测左心室收缩功能。

方法

采用描述性研究设计,根据先前的研究构建了一个假设模型,并从韩国的三家大学医院门诊招募了 191 名 MI 后患者。使用 AMOS 版本 24.0 通过构建结构方程模型来验证修正模型。外生变量为疾病感知、社会支持和抑郁症状。内生变量为自我效能、自我护理依从性和左心室射血分数(LVEF)的变化。

结果

患者的平均年龄和病程分别为 66.3(±11.5)岁和 62.1(±56.6)个月。自我护理依从性直接受自我效能的影响,间接受社会支持的影响。自我护理依从性对 LVEF 变化有直接影响,而 LVEF 变化又与疾病感知、社会支持和自我效能间接相关。

结论

本研究证实了 MI 后随访患者的自我护理依从性对 LVEF 变化的直接影响。有必要定期监测正在进行 MI 后随访的门诊患者的自我护理程度,以防止心脏功能下降。咨询和教育可能是改善低自我护理依从性患者疾病意识和自我效能的有效社会支持形式。

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