疾病侵扰对慢性心力衰竭患者生活质量的影响：身体活动、心理痛苦的链式中介效应

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摘要 目的: 基于应激作用过程模型构建链式中介模型,探讨身体活动、心理痛苦在慢性心力衰竭（CHF）患者疾病侵扰与生活质量之间的中介效应,为改善CHF患者预后提供理论依据。方法: 采用便利抽样法,选取2023年2月—2023年7月在湖南省衡阳市某两所三级甲等医院就诊的229例CHF患者为研究对象。采用一般资料调查表、中文版疾病生活干扰评估量表、国际体力活动问卷（短卷）、心理痛苦温度计、明尼苏达州心力衰竭生存质量量表进行问卷调查,采用偏差校正的百分位Bootstrap法（Process插件）进行链式中介效应检验。结果: CHF患者疾病侵扰得分与身体活动得分呈负相关、与心理痛苦得分和生活质量得分呈正相关;身体活动在疾病侵扰和生活质量之间起部分中介效应,中介效应值为0.087,占总效应值的14.500%;心理痛苦在疾病侵扰和生活质量之间起部分中介效应,中介效应值为0.217,占总效应值的36.167%;身体活动和心理痛苦在疾病侵扰和生活质量之间发挥链式中介效应,中介效应值为0.067,占总效应值的11.166%。结论: CHF患者疾病侵扰可通过身体活动和心理痛苦的中介作用对生活质量产生影响。医护人员应积极关注CHF患者疾病侵扰状况,同时将身体活动与心理痛苦作为干预靶点,促进患者身心康复,进而提升患者生活质量,改善疾病预后。

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	刘雅婷
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关键词 ：慢性心力衰竭, 疾病侵扰, 身体活动, 心理痛苦, 生活质量

Abstract：Objective A multiple mediation model based on the stress action process model was developed to investigate the mediating effects of physical activity and psychological distress on illness intrusiveness and quality of life in patients with chronic heart failure (CHF), as well as to provide a theoretical basis for improving CHF patients' prognoses. Methods A convenience sampling method was used to select 229 CHF patients from two tertiary Grade-A hospitals in Hengyang, Hunan Province, from February to July 2023. A General Information Questionnaire, the Chinese Version of the Illness Intrusiveness Ratings Scale, the International Physical Activity Questionnaire (short volume), the Distress Thermometer, and the Minnesota Living with Heart Failure Questionnaire were used to investigate them. Multiple mediation effect tests were performed using the bias-corrected percentile Bootstrap method (Process plug-in). Results In CHF patients, the illness intrusiveness scores were negatively correlated with physical activity scores and positively correlated with psychological distress scores and quality of life scores; physical activity partially mediated the effect between illness intrusiveness and quality of life, the mediating effect was 0.087, accounting for 14.500% of the total effect value; psychological distress partially mediated the effect between illness intrusiveness and quality of life, the mediating effect was 0.217, accounting for 31.167% of the total effect value; physical activity and psychological distress exerted a multiple mediation effect between illness intrusiveness and quality of life, the mediating effect was 0.067, accounting for 11.166% of the total effect value. Conclusion Illness intrusiveness in CHF patients can impact quality of life through the mediation of physical activity and psychological distress. Healthcare professionals should actively pay attention to illness intrusiveness in CHF patients and, at the same time, take physical activity and psychological distress as intervention targets to promote physical and mental recovery, which in turn will enhance patients' quality of life and improve disease prognosis.

Key words： chronic heart failure illness intrusiveness physical activity psychological distress quality of life

收稿日期: 2023-12-19

中图分类号:

R473

基金资助:湖南省自然科学基金项目“内在能力减退老年冠心病患者心脏康复依从性预测模型的构建及干预策略研究”（2023JJ30426）; 湖南省社会科学成果评审委员会重点课题“基于‘时间银行'的社区智慧居家养老精准服务体系构建研究”（XSP20ZDI013）

通讯作者: 何平平,E-mail：hpp-612@163.com

引用本文:

刘雅婷, 何平平, 刘梦琪, 田丹丹, 张英群. 疾病侵扰对慢性心力衰竭患者生活质量的影响：身体活动、心理痛苦的链式中介效应[J]. 湖南师范大学学报(医学版), 2024, 21(2): 159-164. LIU Yating, HE Pingping, LIU Mengqi, TIAN Dandan, ZHANG Yingqun. The Effect of illness intrusiveness on quality of life of the patients with chronic heart failure: Multiple mediating effect of physical activity and psychological distress. HuNan ShiFan DaXue XueBao(YiXueBan), 2024, 21(2): 159-164.

链接本文:

http://yxb.hunnu.edu.cn/CN/ 或 http://yxb.hunnu.edu.cn/CN/Y2024/V21/I2/159

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