心脏瓣膜置换术后患者资源利用发展轨迹及其与风险感知的差异性分析OA
Trajectories of resource utilization and their differential associations with risk perception in patients after heart valve replacement
目的 探索心脏瓣膜置换术后患者资源利用变化轨迹及影响因素,分析不同轨迹与风险感知的相关性.方法 采用便利抽样法选取194例心脏瓣膜病患者,采用资源利用调查问卷、风险感知问卷在术后(T1)、出院前(T2)、出院后1个月(T3)、出院后3个月(T4)及出院后6个月(T5)对其进行问卷调查.潜类别增长模型、影响因素分析及方差分析两两比较进行数据检验.结果 共识别3条资源利用轨迹,即C1(显著提升组)、C2(缓慢提升组)、C3(持续中低组).不同轨迹类别在年龄(x2=16.255,P=0.012)、文化程度(x2=13.761,P=0.032)、社会支持(x2=11.657,P=0.020)以及应对方式(x2=21.045,P＜0.001)方面存在显著差异.Logistic回归分析显示:年龄、文化程度、社会支持以及应对方式是心脏瓣膜置换术后资源利用变化轨迹的影响因素(P＜0.05).心脏瓣膜置换术后6个月内(T1～T5),各组患者风险感知得分均呈现上升趋势(C1:F=47.260,P＜0.001;C2:F=15.833,P＜0.001;C3:F=4.514,P=0.033);T1～T2 阶段,各组别风险感知水平无显著差异;T3阶段,C1组与C2组患者的风险感知评分均显著高于C3组(P＜0.01);T4～T5阶段,C1组患者的风险感知得分显著高于C2组和C3组(P＜0.001),C2组显著高于C3组(P＜0.01).结论 心脏瓣膜置换术后患者患病后6个月内资源利用呈现3种动态轨迹.资源利用发展轨迹的不同与患者的风险感知密切相关.
Objective To explore the trajectories of resource utilization changes and their influen-cing factors in patients after heart valve replacement,and to analyze the correlation between different trajectories and risk perception.Methods A total of 194 patients with valvular heart disease were selected by convenience sampling.Questionnaires on resource utilization and risk perception were ad-ministered at the time points of postoperation(T1),before discharge(T2),1 month after discharge(T3),3 months after discharge(T4),and 6 months after discharge(T5).Latent class growth mod-eling,influencing factor analysis,and pairwise comparison by analysis of variance were employed for data analysis.Results Three resource utilization trajectories were identified:C1(significant in-crease group),C2(slow increase group),and C3(persistently moderate-low group).Significant differences were found among the trajectory classes in age(x2=16.255,P=0.012),education level(x2=13.761,P=0.032),social support(x2=11.657,P=0.020),and coping style(x2=21.045,P＜0.001).Logistic regression analysis revealed that age,education level,social support,and coping style were influencing factors of resource utilization trajectories after heart valve replacement(P＜0.05).Within 6 months after heart valve replacement(T1 to T5),risk perception scores showed anupward trend in all groups(C1:F=47.260,P＜0.001;C2:F=15.833,P＜0.001;C3:F=4.514,P=0.033).During theT1to T2 period,no significant difference in risk perception was observed among the groups.At T3,the risk perception scores of both the C1 and C2 groups were significantly higher than those of the C3 group(P＜0.01).During the T4 to T5 period,the risk perception score of the C1 group was significantly higher than those of the C2 and C3 groups(P＜0.001),and that of the C2 group was significantly higher than that of the C3 group(P＜0.01).Conclusion Resource utilization in patients after heart valve replacement presents three dynamic trajectories within 6 months postoperatively.The differences in resource utilization trajecto-ries are closely associated with patients' risk perception.
杨洋;薛超;罗建超;吕向妮
空军军医大学第一附属医院心血管外科监护室,陕西西安,710032空军军医大学第一附属医院心血管外科,陕西西安,710032空军军医大学第一附属医院心血管外科监护室,陕西西安,710032空军军医大学第一附属医院心血管外科监护室,陕西西安,710032
医药卫生
心脏瓣膜置换术资源利用发展轨迹风险感知纵向研究影响因素社会支持年龄
heart valve replacementresource utilizationdevelopmental trajectoryrisk per-ceptionlongitudinal studyinfluencing factorssocial supportage
《实用临床医药杂志》 2026 (10)
25-31,7
陕西省自然科学基础研究项目(2021JQ-347)
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