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慢性心力衰竭患者疲劳的异质性:潜在类别与影响因素

Heterogeneity of Fatigue in Patients with Chronic Heart Failure: Latent Categories and Influencing Factors.

作者信息

Yang Xianxian, Wang Wenjun, Xu Yue, Guo Weiting, Guo Yufang

机构信息

Department of Emergency, Qilu Hospital, Shandong University, Jinan, 250000, People's Republic of China.

Department of Cardiology, the second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100853, People's Republic of China.

出版信息

Int J Gen Med. 2025 Feb 19;18:857-866. doi: 10.2147/IJGM.S522314. eCollection 2025.

Abstract

OBJECTIVE

The objective of this study was to analyze the latent categories of fatigue in patients with chronic heart failure (CHF), explore their characteristic differences, and identify the associated influencing factors.

METHODS

This cross-sectional study included 289 patients with CHF who were enrolled at 2 tertiary-level hospitals in Shandong, China, from August to December 2023. The convenience sampling method was used to collect data. Furthermore, the level of fatigue, insomnia, anxiety, depression, and social support were evaluated using the Chinese version of the Multidimensional Fatigue Inventory-20, Insomnia Severity Index, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Multidimensional Scale of Perceived Social Support. Latent profile analysis was performed to elucidate the latent categories of fatigue in the patients. In addition, the risk factors associated with the different categories were assessed using multiple logistic regression analyses.

RESULTS

The average fatigue score was 62.45 ± 13.55. The potential fatigue profile of CHF was divided into three categories: low fatigue group C1 (18.6%), moderate fatigue group C2 (47.4%), and high fatigue group C3 (34.0%). Multiple logistic regression analysis showed that C3 patients with CHF were mainly characterized by lower ejection fraction ( = 0.01, = 0.008), insomnia ( = 1.19, = 0.005), and anxiety ( = 1.20, = 0.034). C2 patients indicated lower ejection fraction ( = 0.04, = 0.040), and C1 patients had higher social support ( = 0.91, < 0.001; = 0.93, < 0.001).

CONCLUSION

This study indicated that CHF patients had significantly heterogeneous levels of fatigue. Therefore, it is recommended that medical staff could adopt more precise interventions according to different category characteristics to improve the outcomes of patients with CHF.

摘要

目的

本研究旨在分析慢性心力衰竭(CHF)患者疲劳的潜在类别,探讨其特征差异,并确定相关影响因素。

方法

本横断面研究纳入了2023年8月至12月在中国山东两家三级医院招募的289例CHF患者。采用便利抽样法收集数据。此外,使用中文版多维疲劳量表-20、失眠严重程度指数、广泛性焦虑障碍-7、患者健康问卷-9和领悟社会支持多维量表评估疲劳、失眠、焦虑、抑郁和社会支持水平。进行潜在类别分析以阐明患者疲劳的潜在类别。此外,使用多因素逻辑回归分析评估与不同类别相关的危险因素。

结果

平均疲劳评分为62.45±13.55。CHF的潜在疲劳类别分为三类:低疲劳组C1(18.6%)、中度疲劳组C2(47.4%)和高疲劳组C3(34.0%)。多因素逻辑回归分析显示,CHF的C3患者主要特征为射血分数较低(β = 0.01,P = 0.008)、失眠(β = 1.19,P = 0.005)和焦虑(β = 1.20,P = 0.034)。C2患者射血分数较低(β = 0.04,P = 0.040),C1患者社会支持较高(β = 0.91,P < 0.001;β = 0.93,P < 0.001)。

结论

本研究表明CHF患者的疲劳水平存在显著异质性。因此,建议医护人员根据不同类别特征采取更精准的干预措施,以改善CHF患者的预后。

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