冠状动脉多支病变患者疲劳现状及其发展轨迹研究

Fatigue status and development trajectory of patients with multivessel coronary disease

中文关键词: 冠状动脉多支病变  疲劳  现状  轨迹  影响因素

英文关键词: multivessel coronary disease  fatigue  status quo  trajectory  influencing factors

中文摘要:

      目的：分析冠状动脉多支病变(MVD)患者疲劳现状，进一步探究疲劳发展轨迹及影响因素。方法：2023年10月至2024年8月，便利抽样选取唐山市3所三甲医院316例MVD患者为研究对象。运用多维疲劳量表在患者入院第3天和出院1、3个月测量其疲劳水平，采用潜类别增长模型识别疲劳发展轨迹分型，并分析不同分型的影响因素。结果：MVD患者基线疲劳得分为(70.32±18.17)分。疲劳发展轨迹分为缓慢缓解、低水平波动、快速下降和持续高水平四个潜在分型。多因素分析结果显示，与持续高水平组相比，MVD患者发展为缓慢缓解组的影响因素为心理韧性，发展为低水平波动组的影响因素为高中及以上学历、抑郁、运动恐惧和心理韧性，发展为快速下降组的影响因素为高中及以上学历和心理韧性(P＜0.05)。结论：MVD患者基线疲劳程度严重，疲劳发展轨迹存在群体异质性，护士应重视文化水平低者，提升患者的心理韧性水平，降低抑郁和运动恐惧心理以缓解疲劳。

英文摘要:

      Objective: To analyze the status quo of fatigue in patients with multivessel coronary disease (MVD) and to further explore the development trajectory and predictive factors of fatigue. Methods: From October 2023 to August 2024, a total of 316 MVD patients from 3 tertiary hospitals in Tangshan were selected as the research objects by convenience sampling. The Multidimensional Fatigue Inventory was used to measure the fatigue level of patients on the third day of admission and 1 and 3 months after discharge. The Latent Class Growth Model was used to identify the types of fatigue development trajectory, and the influencing factors of different types were analyzed. Results: The baseline fatigue score of patients with MVD was (70.32±18.17). The fatigue development trajectory can be divided into four potential types: slow relief, low-level fluctuation, rapid decline, and sustained high-level. Theresults of themultivariate analysis showed that compared with the sustained high-level group, the influencing factors of patients with MVD developing into the slow relief group was resilience scores.The influencing factors of thelow-level fluctuation group were high school education or above, depression, kathisophobia and resilience. The factors influencing the development of rapid decline group were high school education or above and resilience(P＜0.05) . Conclusions: Patients with MVD have serious fatigue at baseline, and there is group heterogeneity in the fatigue development trajectory. Nurses should pay attention to patients with low education levels, improve the resilience of patients at an early stage, continue to pay attention to patients" depression and kathisophobia, and give patients stage and specific interventions to reduce fatigue.