| ObjectiveThe present situation of self-management,self-perceived burden and life quality of rural patients with heart failure was analyzed,and the influencing factors of life quality of rural patients with heart failure were discussed.The relationship among self-management,self-perceived burden and quality of life in rural patients with heart failure was analyzed,and the influence mechanism of self-management and self-perceived burden on quality of life of patients with heart failure was further explored.It provides theoretical and practical basis for the improvement of life quality of rural patients with heart failure.MethodsThis study is an investigation.Rural patients with chronic heart failure who were admitted to the department of cardiology of a grade iii first-class hospital from December 2018 to January 2020 were selected as research objects.During the survey period,269 patients participated in this study,and the effective rate of the questionnaire was 94%.The research tool was(1)the general condition questionnaire,which included the patients’ socio-demographic and clinical data:age,gender,marital status,education level,occupational status,residence,per capita monthly income,LVEF,NYHA classification of cardiac function,BMI,duration of heart failure,number of hospitalizations for heart failure,and number of complications.(2)the self-management scale for heart failure patients includes five dimensions:self-management confidence,self-management behavior,self-management cognition,self-psychological management and self-management information.(3)self-perceived burden scale,which contains 10 items,has three dimensions:economic burden,emotional burden and physical burden.(4)12-item Short Form Health Survey(sf-12)was used to measure the quality of life of rural patients with chronic heart failure.It includes 2 parts of physical dimension and psychological dimension and 8 sub-dimensions.The above questionnaires were collected by specially trained members of the research group.Under the principle of informed consent of patients,a unified collection of questionnaires was completed for patients meeting the standards.SPSS17.0 and AMOS 17.0 analysis software were used for data analysis,hypothesis and model test.Descriptive statistical analysis:mainly used frequency,composition ratio,etc.to describe the demographic data of the survey object to understand the distribution of the sample.Analysis of variance(or)t test and multiple linear regression:one-way analysis of variance and independent sample t test were used to test whether there were significant differences between the physical and psychological dimensions of life quality of demographic data.Taking the significant factors in the univariate analysis as independent variables,the multiple regression equation was established to analyze whether there were significant differences.Correlation analysis:Pearson correlation analysis was used in this study to analyze the relationship among the three variables of patients’ self-management,self-perceived burden and quality of life.Structural equation modeling technology:by using structural equation modeling technology,the relationship model of self-management,self-perceived burden and quality of life was established,and the influence mechanism of self-management and self-perceived negative on patients’quality of life was discussed.Results1.Comparison of body dimension scores of patients’ quality of life.The average score of physical dimension of quality of life in patients with chronic heart failure was(50.00±8.16).There was a statistically significant difference between age and physical dimension score of quality of life(F=18.834,P<0.01).Compared with working patients,inactive patients had lower physical dimension score of quality of life(t=5.005,P<0.01).The body dimension scores of patients with different cardiac function classification showed statistical difference(P<0.01),and the body dimension scores of patients with disease duration of>for 6 months were lower than those with disease duration of<6 months,and the difference was statistically significant(t=4.187,P<0.01).The score of physical dimension of quality of life of patients with>for 3 times of hospitalization for heart failure was lower than that of patients with<3 times of hospitalization,and there was a statistical difference in score(t=4.328,P<0.01).Age,working status,and cardiac function grade accounted for 22.0%variation in somatic dimension of quality of life in patients with chronic heart failure(adjusted R2=0.220).2.Comparison of scores of psychological dimension of patients’ quality of lifeThe average score of psychological dimension of quality of life in patients with chronic heart failure was(49.99±9.45).Age and life quality,and the psychological dimension score difference was statistically significant(F=12.024,P<0.01),cardiac function grading the quality of life of patients with different mental dimension scores statistically difference(F=8.425,P<0.01),course>6 months scored lower on the quality of life in patients with psychological dimensions of course<6 months,and the difference is statistically significant(t=2.157,P=0.032).The score of psychological dimension of quality of life of patients with>times of hospitalization for heart failure was lower than that of patients with<3 times of hospitalization,and there was a statistical difference in score(P=0.012).There were statistical differences in scores of psychological dimension of quality of life of per capita monthly income(F=12.436,P<0.01).After multiple comparisons,patients with per capita monthly income<1000 yuan scored lower than patients with psychological dimension of quality of life of 1000-3000 yuan and patients with>3000 yuan(all P<0.01).BMI and per capita monthly income accounted for 34.2%of the variation in somatic dimension of quality of life in patients with chronic heart failure(adjusted R2=0.342).3.Correlation analysis between self-management and quality of life in patients with chronic heart failure The self-management score of patients with chronic heart failure in rural areas was in the middle level of self-management,with the total score(99.51±17.08).Points.The average score from high to low was:self-management confidence(3.25±0.79),self-psychological management(3.23±0.62),self-management cognition(3.11±0.76)and self-management behavior(3.05±0.62).The correlation coefficient between self-management and quality of life in patients with chronic heart failure(r=0.300,P<0.05)was statistically significant.4.Correlation analysis between self-perceived burden and quality of life in patients with chronic heart failure The self-perceived burden score of patients with chronic heart failure in rural areas was shown,with the total score of(40.47±4.72)and the score distributed between 14 and 50 points,which was at the level of severe burden.The burden scores of each dimension were from heavy to light:physical burden(18.51±2.51),emotional burden(14.97±1.01),and economic burden(6.99±1.20).The correlation coefficient between self-perceived burden and quality of life in patients with chronic heart failure(r=0.438,P<0.05)was statistically significant.Conclusion1.The quality of life of rural patients is at a medium level,but far lower than that of urban patients.2.The influencing factors of rural patients’ quality of life include age,working status,cardiac function classification,BMI and per capita monthly income.3.The self-management ability of rural patients is at medium level,among which the two dimensions of self-management cognition and self-management behavior are at low level.The self-management ability is positively correlated with the total score of life quality and its various dimensions,that is,the better the self-management ability,the higher the quality of life.4.The rural patients’ self-perceived burden is at a severe level.Among them,the dimension of body burden is at a high level.The self-perceived burden was negatively correlated with the total score of life quality and its various dimensions.The higher the self-perceived burden was,the worse the life quality was. |
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