Huang Wanbing, Wu Qiansheng, Zhang Yufen, Zhu Hongmei
School of Nursing, Jianghan University, Wuhan, Hubei, China.
Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Health Qual Life Outcomes. 2025 Jun 7;23(1):60. doi: 10.1186/s12955-025-02392-w.
Aortic dissection (AD) is a rare but dangerous cardiovascular condition, and research on the health-related quality of life (HRQOL) of postoperative patients after discharge is limited. This study aimed to classify patterns of HRQOL among this population, and to examine the psychological and social factors associated with different HRQOL categories based on the common sense model of self-regulation and the social-cognitive processing model.
A cross-sectional study was conducted in two tertiary general hospitals in Wuhan from January 2022 to August 2022. HRQOL was assessed via the validated Patient-Reported Outcomes Measurement Information System 29-item Profile. Characteristic categories of HRQOL were identified through exploratory latent profile analysis. Univariate analysis and multinominal logistic regression were employed to explore the factors associated with HRQOL.
Among the 379 patients, the mean health utility was 0.36 ± 0.17. A total of 35.4% and 32.5% of the patients had obvious anxiety and depression, respectively. The patients were divided into three HRQOL subgroups: "high psychological distress-pain group" (29.0%), "mild functional impairment-anxiety group" (49.3%), and "mild functional impairment-adaptation group" (21.6%). Significant factors associated with HRQOL included age, AD type, illness cognitive representation, fear of disease progression, daily life management and exercise (P < 0.05).
The self-reported health status of postoperative AD patients is concerning. HRQOL within this population displays significant heterogeneity, and stratified care tailored to each group is recommended. Interventions targeting cognitive representations and fear reduction may enhance HRQOL. Continuous care to facilitate self-management behaviors is essential for improving health outcomes for postoperative AD patients. These findings require further longitudinal and interventional studies to confirm.
主动脉夹层(AD)是一种罕见但危险的心血管疾病,关于出院后术后患者健康相关生活质量(HRQOL)的研究有限。本研究旨在对该人群的HRQOL模式进行分类,并基于自我调节的常识模型和社会认知加工模型,探讨与不同HRQOL类别相关的心理和社会因素。
于2022年1月至2022年8月在武汉的两家三级综合医院进行了一项横断面研究。通过经过验证的患者报告结局测量信息系统29项量表评估HRQOL。通过探索性潜在类别分析确定HRQOL的特征类别。采用单因素分析和多项逻辑回归探讨与HRQOL相关的因素。
在379例患者中,平均健康效用值为0.36±0.17。分别有35.4%和32.5%的患者存在明显的焦虑和抑郁。患者被分为三个HRQOL亚组:“高心理困扰-疼痛组”(29.0%)、“轻度功能障碍-焦虑组”(49.3%)和“轻度功能障碍-适应组”(21.6%)。与HRQOL相关的显著因素包括年龄、AD类型、疾病认知表征、对疾病进展的恐惧、日常生活管理和运动(P<0.05)。
AD术后患者自我报告的健康状况令人担忧。该人群的HRQOL存在显著异质性,建议针对每组进行分层护理。针对认知表征和减轻恐惧的干预措施可能会提高HRQOL。持续护理以促进自我管理行为对于改善AD术后患者的健康结局至关重要。这些发现需要进一步的纵向和干预性研究来证实。