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心梗患者重返工作岗位后的健康相关生命质量及其相关因素:一项横断面研究。

Health-related quality of life and associated factors in patients with myocardial infarction after returning to work: a cross-sectional study.

机构信息

The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China.

School of Statistics, Henan University of Economics and Law, Zhengzhou, 450046, China.

出版信息

Health Qual Life Outcomes. 2020 Jun 17;18(1):190. doi: 10.1186/s12955-020-01447-4.

Abstract

BACKGROUND

Return to work following myocardial infarction (MI) represents an important indicator of recovery. However, MI can cause patients to feel pressure, loneliness and inferiority during work and even detachment from employment after returning to work, which may affect their quality of life. The aims of this study were to identify the influencing factors of Health-related quality of life (HRQoL) in patients with MI after returning to work and explore the correlations between these factors and HRQoL.

METHOD

This was a cross-sectional study. All participants were recruited from tertiary hospitals in China from October 2017 to March 2018. The general data questionnaire, Short-Form Health Survey-8 (SF-8), Health Promoting Lifestyle ProfileII (HPLPII), Medical Coping Modes Questionnaire (MCMQ) and Social Supporting Rating Scale (SSRS) were used to assess 326 patients with myocardial infarction returned to work after discharge. Multiple linear regression analysis was performed to explore factors related to HRQoL in patients with MI after returning to work.

RESULTS

The sample consisted of 326 patients. The mean total score of quality of life was 28.03 ± 2.554. According to the multiple linear regression analysis, next factors were associated with better HRQoL: younger age (B = - 0.354, P = 0.039), higher income (B = 0.513, P = 0.000), less co-morbidity (B = - 0.440, P = 0.000), the longer time taken to return to work (B = 0.235, P = 0.003), fewer stents installed (B = - 0.359, P = 0.003), participation in cardiac rehabilitation (CR) (B = - 1.777, P = 0.000), complete CR (B = - 1.409, P = 0.000), better health behaviors such as more health responsibility (B = 0.172, P = 0.000) and exercise (B = 0.165, P = 0.000), better nutrition (B = 0.178, P = 0.000) and self-realization (B = 0.165, P = 0.000), stress response (B = 0.172, P = 0.000), more social support such as more objective support (B = 0.175, P = 0.000), subjective support (B = 0.167, P = 0.000) and better utilization of social support (B = 0.189, P = 0.028), positive copping strategies such as more coping (B = 0.133, P = 0.000) and less yield (B = - 0.165, P = 0.000).

CONCLUSIONS

HRQoL of MI patients after returning to work is not satisfactory. Health behavior, coping strategies, social support are factors which can affect HRQoL. A comprehensive and targeted guide may be a way to improve HRQoL and to assist patients' successful return to society.

摘要

背景

心肌梗死后重返工作岗位是恢复的一个重要指标。然而,心肌梗死后,患者在工作中可能会感到压力、孤独和自卑,甚至在重返工作岗位后与就业脱节,这可能会影响他们的生活质量。本研究的目的是确定影响心肌梗死后重返工作岗位患者健康相关生活质量(HRQoL)的因素,并探讨这些因素与 HRQoL 的相关性。

方法

这是一项横断面研究。所有参与者均来自中国的三甲医院,于 2017 年 10 月至 2018 年 3 月招募。采用一般资料问卷、简明健康状况量表-8 (SF-8)、健康促进生活方式量表 II(HPLPII)、医学应对方式问卷(MCMQ)和社会支持评定量表(SSRS)对 326 例心肌梗死后出院重返工作岗位的患者进行评估。采用多元线性回归分析探讨与心肌梗死后重返工作岗位患者 HRQoL 相关的因素。

结果

样本包括 326 例患者。生活质量总分平均为 28.03±2.554。根据多元线性回归分析,以下因素与更好的 HRQoL 相关:年龄较小(B=-0.354,P=0.039)、收入较高(B=0.513,P=0.000)、合并症较少(B=-0.440,P=0.000)、重返工作岗位时间较长(B=0.235,P=0.003)、支架植入数量较少(B=-0.359,P=0.003)、参加心脏康复(CR)(B=-1.777,P=0.000)、完成 CR(B=-1.409,P=0.000)、健康行为较好,如健康责任(B=0.172,P=0.000)和运动(B=0.165,P=0.000)、营养较好(B=0.178,P=0.000)和自我实现(B=0.165,P=0.000)、应激反应较好(B=0.172,P=0.000)、社会支持较多,如客观支持(B=0.175,P=0.000)、主观支持(B=0.167,P=0.000)和更好地利用社会支持(B=0.189,P=0.028)、积极的应对策略较多,如应对(B=0.133,P=0.000)和屈服(B=-0.165,P=0.000)较少。

结论

心肌梗死后重返工作岗位患者的 HRQoL 不尽如人意。健康行为、应对策略、社会支持是影响 HRQoL 的因素。全面有针对性的指导可能是提高 HRQoL 并帮助患者成功重返社会的一种方法。

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