扩张型心肌病患者自我效能感及自我管理行为与病情转归的相关性分析

夏红云; 徐娜; 刘超

doi:10.16766/j.cnki.issn.1674-4152.004251

扩张型心肌病患者自我效能感及自我管理行为与病情转归的相关性分析

doi: 10.16766/j.cnki.issn.1674-4152.004251

青岛市市立医院心内一科，山东青岛 266071

基金项目:

山东省医药卫生科技发展计划项目 202203010192

详细信息

通讯作者:
刘超，E-mail：1026548949qq.com

中图分类号: R542.2
计量
- 文章访问数: 5
- HTML全文浏览量: 2
- PDF下载量: 0
- 被引次数: 0
出版历程
- 收稿日期: 2025-03-11
- 网络出版日期: 2026-01-07

Correlation among self-efficacy, self-management behavior and outcome in patients with dilated cardiomyopathy

Department of Cardiology, Qingdao Municipal Hospital, Qingdao, Shandong 266071, China

摘要

摘要: 目的探讨扩张型心肌病(DCM)患者的自我效能感、自我管理行为与病情转归的相关性，旨在进一步改善DCM预后。方法选取2021年1月—2022年12月青岛市市立医院收治的200例DCM患者作为研究对象，根据随访结果分为死亡组和存活组。通过问卷调查法收集患者的一般自我效能感量表(GSES)得分和《DCM治疗患者自我管理能力调查问卷》得分，并使用Spearman相关分析法研究其与病情转归的关系。结果 GSES评估结果对比，存活组症状管理自我效能[(10.88±2.50)分]、疾病共性管理自我效能得分[(14.84±2.01)分]以及GSES总分[(25.72±5.96)分]均高于死亡组[(7.88±1.92)分、(11.27±3.06)分、(19.15±6.02)分，P＜0.05]。存活组自我管理行为各项子量表得分以及总分均高于死亡组(P＜0.05)。症状管理自我效能(r=0.482)、疾病共性管理自我效能(r=0.360)、GSES总分(r=0.423)、遵医用药(r=0.650)、饮食管理(r=0.314)、并发症预防(r=0.897)、疾病监测(r=0.632)以及自我管理行为总分(r=0.625)均与DCM预后呈正相关关系(P＜0.05)。结论 DCM患者的自我效能感和自我管理行为与其预后息息相关，提高DCM患者自我效能感和自我管理行为有利于改善预后。
- 扩张型心肌病 /
- 自我效能感 /
- 自我管理行为 /
- 病情转归
Abstract: Objective To explore the correlation among self-efficacy, self-management behavior and prognosis in patients with dilated cardiomyopathy (DCM), in order to further improve the prognosis of DCM. Methods Two hundred patients with DCM admitted to Qingdao Municipal Hospital from January 2021 to December 2022 were selected as the research objects and divided into death group and survival group according to the follow-up results. The scores of the general self-efficacy scale (GSES) and the "questionnaire on self-management ability of DCM treatment patients" of the patients were collected through the questionnaire survey method, and the Spearman correlation analysis method was used to study the relationship between them and the prognosis of the disease. Results Comparison of GSES assessment results, the self-efficacy of symptom management [(10.88±2.50) points], the score of disease commonality management self-efficacy [(14.84±2.01) points] and the total score of GSES [(25.72±5.96) points] in the survival group were all higher than those in the death group [(7.88±1.92) points, (11.27±3.06) points, (19.15±6.02) points, P < 0.05]. The comparison of self-management behaviors showed that the scores of each sub-scale and the total score were all higher than those of the death group (P < 0.05). Symptom management self-efficacy (r=0.482), disease commonality management self-efficacy (r=0.360), total score of GSES (r=0.423), medication compliance (r=0.650), diet management (r=0.314), complication prevention (r=0.897), disease surveillance (r=0.632), and total score of self-management behavior (r=0.625) were all positively correlated with the prognosis of DCM (P < 0.05). Conclusion The self-efficacy and self-management behavior of DCM patients are closely related to the prognosis and improving patients ' self-efficacy and self-management behavior of DCM patients may be conducive to improving the prognosis.
- Dilated cardiomyopathy /
- Self-efficacy /
- Self-management behavior /
- Disease outcome

HTML全文

表 1 2组DCM患者一般资料比较

Table 1. Comparison of general data of DCM patients between the two groups

组别	例数	性别[例(%)]		年龄 (x±s，岁)	BMI (x±s)	血压(x±s，mmHg)		不良生活习惯[例(%)]		LVEDD (x±s，mm)	LVEF (x±s，%)
组别	例数	男性	女性	年龄 (x±s，岁)	BMI (x±s)	SBP	DBP	吸烟史	饮酒史	LVEDD (x±s，mm)	LVEF (x±s，%)
存活组	154	80(51.95)	74(48.05)	60.75±8.55	24.58±2.70	117.05±5.70	80.68±4.65	50(32.47)	70(45.45)	70.25±5.75	30.71±4.22
死亡组	46	19(41.30)	27(58.70)	62.73±10.24	23.71±2.91	115.92±7.35	79.44±6.83	21(45.65)	19(41.30)	68.54±6.11	31.24±3.81
统计量		1.605^a		1.315^b	1.883^b	1.100^b	1.412^b	2.689^a	0.247^a	1.745^b	0.764^b
P值		0.205		0.190	0.061	0.273	0.159	0.101	0.619	0.083	0.446

组别	例数	合并症[例(%)]						QRS波宽度 (x±s，ms)	血肌酐 (x±s，μmol/L)	总胆固醇 (x±s，μmol/L)
组别	例数	心房颤动/心房扑动	高血压	冠心病	慢阻肺	慢性肾脏疾病	糖尿病	QRS波宽度 (x±s，ms)	血肌酐 (x±s，μmol/L)	总胆固醇 (x±s，μmol/L)
存活组	154	37(24.03)	25(16.23)	20(12.99)	9(5.84)	4(2.60)	24(15.58)	104.95±7.83	90.57±4.85	4.02±1.29
死亡组	46	15(32.61)	9(19.57)	8(17.39)	3(6.52)	4(8.70)	8(17.39)	106.68±9.42	88.92±6.70	4.18±0.95
统计量		1.356^a	0.279^a	0.571^a	0.029^a	3.430^a	0.086^a	1.253^b	1.843^b	0.780^b
P值		0.244	0.598	0.450	0.865	0.064	0.769	0.212	0.067	0.436
注：^a为χ²值，^b为t值。1 mmHg=0.133 kPa。

下载: 导出CSV

表 2 2组DCM患者GSES评分比较(x±s，分)

Table 2. Comparison of GSES scores between the two groups of DCM patients (x±s, points)

组别	例数	症状管理自我效能	疾病共性管理自我效能	总分
存活组	154	10.88±2.50	14.84±2.01	25.72±5.96
死亡组	46	7.88±1.92	11.27±3.06	19.15±6.02
t值		7.500	7.447	6.546
P值		＜0.001	＜0.001	＜0.001

下载: 导出CSV

表 3 2组DCM患者自我管理行为评分比较(x±s，分)

Table 3. Comparison of self-management behavior scores of DCM patients between the two groups(x±s, points)

组别	例数	遵医用药	饮食管理	运动管理	并发症预防	疾病监测	总分
存活组	154	3.80±0.15	3.31±0.50	1.01±0.30	3.11±0.29	1.97±0.60	13.20±3.72
死亡组	46	1.98±0.52	2.47±0.66	0.83±0.23	0.98±0.31	0.88±0.27	7.14±1.90
t值		38.576	9.249	3.751	43.021	11.949	14.770
P值		＜0.001	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

下载: 导出CSV

参考文献(20)

[1]	张舒媛, 高仕奇, 王泽源, 等. 扩张型心肌病患者长期预后及危险因素分析[J]. 中华心血管病杂志, 2024, 52(4): 384-390. ZHANG S Y, GAO S Q, WANG Z Y, et al. Analysis of long-term prognosis and risk factors in patients with dilated cardiomyopathy[J]. Chinese Journal of Cardiology, 2024, 52(4): 384-390.
[2]	胡盛惠, 姚立影, 魏薇, 等. β1受体阻滞剂防治脓毒症心肌病作用的研究进展[J]. 中国临床新医学, 2024, 17(2): 227-232. HU S H, YAO L Y, WEI W, et al. Research progress in the effect ofβ1-receptor blockers on prevention and treatment of sepsis-induced cardiomyopathy[J]. Chinese Journal Of New Clinical Medicine, 2024, 17(2): 227-232.
[3]	邱月清, 王振涛, 陈振翼, 等. 调节性细胞死亡在扩张型心肌病中的研究进展[J]. 中国比较医学杂志, 2024, 34(5): 113-125. QIU Y Q, WANG Z T, CHEN Z Y, et al. Research progress on the relationship between regulatory cell death and dilated cardiomyopathy[J]. Chinese Journal of Comparative Medicine, 2024, 34(5): 113-125.
[4]	邱清勇, 彭锦, 刘大勇. 基线HE4水平对扩张型心肌病患者药物治疗反应性的评估[J]. 心脏杂志, 2023, 35(3): 310-315. QIU Q Y, PENG J, LIU D Y. Evaluation of baseline HE4 levels and drug therapy responsiveness in patients with dilated cardiomyopathy[J]. Chinese Heart Journal, 2023, 35(3): 310-315.
[5]	沈月英, 王楠, 张玥. 心肌收缩力调节器的研究进展[J]. 新医学, 2023, 54(4): 250-253. SHEN Y Y, WANG N, ZHANG Y. Cardiac contractility modulator: new hope for heart failure patients[J]. Journal of New Medicine, 2023, 54(4): 250-253.
[6]	唐妙, 胡永奎. 以智谋理论为框架的协同干预对ST段抬高型心肌梗死介入治疗后患者反刍性沉思及自我效能感的影响[J]. 中国医药导报, 2024, 21(10): 167-171. TANG M, HU Y K. Effects of collaborative intervention with the framework of resourcefulness theory on rumination meditation and self efficacy of ST-segment elevation myocardial infarction patients after interventional therapy[J]. China Medical Herald, 2024, 21(10): 167-171.
[7]	张密, 马先莉. 基于协同护理模式的心脏康复对永久性起搏器植入患者自我管理行为、照顾者照顾能力的影响[J]. 国际护理学杂志, 2024, 43(6): 989-995. ZHANG M, MA X L. Effects of cardiac rehabilitation based on a collaborative care model on self-management behaviors, and caregiver caregiving abilities in patients with permanent pacemaker implants[J]. International Journal Of Nursing, 2024, 43(6): 989-995.
[8]	ARBELO E, PROTONOTARIOS A, GIMENO J R, et al. 2023 ESC Guidelines for the management of cardiomyopathies[J]. Eur Heart J, 2023, 44(37): 3503-3626.
[9]	郭晶晶, 袁河新, 张丹锋. 基于IMPACT模式的临床干预在冠心病患者中的应用及对预后的影响[J]. 中国循证心血管医学杂志, 2023, 15(1): 106-108. GUO J J, YUAN H X, ZHANG D F. Application of clinical intervention based on IMPACT mode and its influence on prognosis in patients with coronary heart disease[J]. Chinese Journal of Evidence-Based Cardiovascular Medicine, 2023, 15(1): 106-108.
[10]	董忻悦, 张贤, 沈志云, 等. 扩张型心肌病护理实践规范[J]. 中国分子心脏病学杂志, 2023, 23(2): 5239-5249. DONG X Y, ZHANG X, SHEN Z Y, et al. Standard of practice on the care of dilated cardiomyopathy[J]. Molecular Cardiology of China, 2023, 23(2): 5239-5249.
[11]	HEYMANS S, LAKDAWALA N K, TSCHÖPE C, et al. Dilated cardiomyopathy: causes, mechanisms, and current and future treatment approaches[J]. Lancet, 2023, 402(10406): 998-1011. doi: 10.1016/S0140-6736(23)01241-2
[12]	ORPHANOU N, PAPATHEODOROU E, ANASTASAKIS A. Dilated cardiomyopathy in the era of precision medicine: latest concepts and developments[J]. Heart Fail Rev, 2022, 27(4): 1173-1191. doi: 10.1007/s10741-021-10139-0
[13]	HARDING D, CHONG M H A, LAHOTI N, et al. Dilated cardiomyopathy and chronic cardiac inflammation: pathogenesis, diagnosis and therapy[J]. J Intern Med, 2023, 293(1): 23-47. doi: 10.1111/joim.13556
[14]	谭慧慧, 王宝华, 蒋辉. 扩张型心肌病合并肺动脉高压的危险因素及对预后的影响[J]. 中国循证心血管医学杂志, 2023, 15(12): 1353-1355. TAN H H, WANG B H, JIANG H. Risk factors of dilated cardiomyopathy complicated by pulmonary arterial hypertension and their influence on prognosis[J]. Chinese Journal of Evidence-Based Cardiovascular Medicine, 2023, 15(12): 1353-1355.
[15]	李军, 胡泽平, 朱学涛. 扩张型心肌病患者心内血栓形成危险因素及预测模型研究[J]. 安徽医科大学学报, 2024, 59(4): 708-714. LI J, HU Z P, ZHU X T. Research on the risk factors and predictive model for intracardiac thrombosis in patients with dilated cardiomyopathy[J]. Acta Universitatis Medicinalis Anhui, 2024, 59(4): 708-714.
[16]	刘磊, 罗贵全, 刘溢均, 等. 老年扩张型心肌病并发恶性心律失常的危险因素与远期预后分析[J]. 中华全科医学, 2023, 21(6): 958-961. doi: 10.16766/j.cnki.issn.1674-4152.003024 LIU L, LUO G Q, LIU Y J, et al. Risk factors and long-term prognosis of malignant arrhythmia in elderly patients with dilated cardiomyopathy[J]. Chinese Journal of General Practice, 2023, 21(6): 958-961. doi: 10.16766/j.cnki.issn.1674-4152.003024
[17]	田亚男. 左西孟旦联合认知行为疗法对扩张型心肌病合并慢性心力衰竭的效果分析[J]. 河北医药, 2022, 44(12): 1795-1798, 1803. TIAN Y N. The clinical efficacy of levosimendan combined with cognitive behavior therapy for patients with dilated cardiomyopathy complicated by chronic heart failure[J]. Hebei Medical Journal, 2022, 44(12): 1795-1798, 1803.
[18]	金佳敏, 巩倩, 庄乐南. 扩张型心肌病动物模型及治疗的研究进展[J]. 浙江大学学报(农业与生命科学版), 2024, 50(1): 1-11. JIN J M, GONG Q, ZHUANG L N. Advances in animal models and treatment of dilated cardiomyopathy[J]. Journal of Zhejiang University: Agriculture and Life Sciences, 2024, 50(1): 1-11.
[19]	杜家琦, 姚瑞, 郝正阳, 等. 外周血NLR、MHR对扩张型心肌病患者发生冠状动脉粥样硬化的影响及预测效能[J]. 山东医药, 2022, 62(9): 86-89. DU J Q, YAO R, HAO Z Y, et al. The influence and predictive efficacy of peripheral blood NLR and MHR on coronary atherosclerosis in patients with dilated cardiomyopathy[J]. Shandong Medical Journal, 2022, 62(9): 86-89.
[20]	屈江艳, 宋宝梅, 金茜, 等. 心率及个体化管理对老年扩张型心肌病患者心理状态及运动耐力的影响[J]. 老年医学与保健, 2022, 28(4): 851-855. QU J Y, SONG B M, JIN Q, et al. Effects of heart rate and individualized management on mental state and exercise endurance of elderly patients with dilated cardiomyopathy[J]. Geriatrics & Health Care, 2022, 28(4): 851-855.