Chai Zhuo, Fan Yuxuan, Gong Xue, Zhang Yue, Hu Yanling, Li Xiaowei, Fan Zhiqing, Han Yongkui
Department of Nursing, Harbin Medical University, Daqing, Heilongjiang, China.
Department of Rehabilitation, Tongji Hospital Affiliated to Tongji University, Tongji University School of Medicine, Shanghai, China.
Front Cardiovasc Med. 2025 Feb 24;12:1460855. doi: 10.3389/fcvm.2025.1460855. eCollection 2025.
Coronary heart disease seriously jeopardizes human health and has become a principal public health problem of global concern. While percutaneous coronary intervention (PCI) repairs narrowed arteries and extends patients' lives, cardiac rehabilitation offers additional benefits post-PCI. Numerous previous studies have shown that cardiac rehabilitation can inhibit the progression of atherosclerotic plaques in patients after coronary intervention, effectively controlling patients' clinical symptoms and improving their quality of life. However, the current status of adherence to phase I cardiac rehabilitation is poor, and the variation in adherence to phase I cardiac rehabilitation among post-PCI patients in China are not well understood. This study aimed to identify the heterogeneity of adherence to phase I cardiac rehabilitation and its influencing factors in post-PCI patients through latent class analysis (LCA) to support individualized interventions.
PCI patients ( = 212) admitted to the Cardiac Rehabilitation Center of Daqing Oilfield General Hospital in Heilongjiang Province were selected to complete the General Demographic Information Questionnaire, Cardiac Rehabilitation Adherence Scale for Coronary Heart Disease Patients, Cardiac Rehabilitation Knowledge Questionnaire, Patient Health Questionnaire-9 (PHQ-9), Social Support Rating Scale, Tampa Scale for Kinesiophobia-Swedish Version (TSK-SV), and Chronic Disease Resource Survey Questionnaire at the end of phase I cardiac rehabilitation. Latent class analysis identified potential categories of adherence to phase I cardiac rehabilitation in post-PCI patients. Logistic regression analyzed the factors influencing the different categories.
Adherence to phase I cardiac rehabilitation in post-PCI patients was classified into three groups: Good Adherence (31.2%), Poor Nutritional and Psychological Management (32.0%), and Lack of Exercise (36.8%). Limited social support, poor utilization of chronic disease resources, low education level, a history of alcohol consumption, and kinesiophobia are factors influencing the different latent subgroups ( < 0.05).
Heterogeneity exists in the adherence to phase I cardiac rehabilitation of post-PCI patients. Healthcare professionals should implement targeted interventions based on the characteristics of each category to improve adherence.
冠心病严重危害人类健康，已成为全球关注的主要公共卫生问题。虽然经皮冠状动脉介入治疗（PCI）可修复狭窄动脉并延长患者生命，但心脏康复在PCI术后具有额外益处。此前众多研究表明，心脏康复可抑制冠状动脉介入术后患者动脉粥样硬化斑块的进展，有效控制患者临床症状并改善其生活质量。然而，目前I期心脏康复的依从性状况不佳，且中国PCI术后患者I期心脏康复依从性的差异尚不明确。本研究旨在通过潜在类别分析（LCA）确定PCI术后患者I期心脏康复依从性的异质性及其影响因素，以支持个体化干预。
选取黑龙江省大庆油田总医院心脏康复中心收治的PCI患者（n = 212），在I期心脏康复结束时完成一般人口学信息问卷、冠心病患者心脏康复依从性量表、心脏康复知识问卷、患者健康问卷-9（PHQ-9）、社会支持评定量表、坦帕运动恐惧量表瑞典版（TSK-SV）以及慢性病资源调查问卷。潜在类别分析确定PCI术后患者I期心脏康复依从性的潜在类别。逻辑回归分析影响不同类别的因素。
PCI术后患者I期心脏康复依从性分为三组：良好依从（31.2%）、营养与心理管理不佳（32.0%）以及缺乏运动（36.8%）。社会支持有限、慢性病资源利用不佳、教育水平低、饮酒史以及运动恐惧是影响不同潜在亚组的因素（P < 0.05）。
PCI术后患者I期心脏康复依从性存在异质性。医护人员应根据各亚组特征实施针对性干预，以提高依从性。
