| Objective:The aims of this study were to investigate the level of resourcefulness in patients with chronic heart failure,and to explore the influencing factors of the resourcefulness from physiological,situational,psychological aspects,and to build a network model.These are expected to provide scientific basis for formulating effective interventions to improve the patients’ resourcefulness.Methods:Using the cross-sectional study design and convenient sampling method,219 patients with chronic heart failure were investigated from three tertiary grade-A hospitals in Shandong Province from December 2021 to December 2022.The survey tools included the general data questionnaire,Resourcefulness Scale,Symptom Status Questionnaire-Heart Failure,Lubben Social Network Scale-6,Perceived Social Support Scale,Cognitive Emotion Regulation Questionnaire and Personal Mastery Scale.SPSS 26.0 and R 4.2.2 were used for data collation and analysis.Statistical methods included descriptive statistics,independent sample t test,one-way analysis of variance,Pearson correlation analysis,multiple linear regression analysis and network analysis.Results:1.The score for resourcefulness in patients with chronic heart failureThe mean score for resourcefulness was(77.04 ± 13.23),the total score for resourcefulness in patients with chronic heart failure ranged from 52 to 125.In this study,30 patients(13.7%)had low level of resourcefulness,160 patients(73.1%)had moderate and 29 patients(13.2%)had high level of resourcefulness.The mean score was(42.86±9.40)and item mean score was(2.68±0.59)for personal resourcefulness.The mean score was(34.18 ±6.30)and item mean score was(2.84±0.52)for social resourcefulness.2.Relationships between general characteristics and resourcefulness in patients with chronic heart failureAge was negatively correlated with resourcefulness score(r=-0.321,P<0.001),personal resourcefulness score(r=-0.335,P<0.001),and social resourcefulness score(r=-0.173,P<0.01).BMI was positively correlated with resourcefulness score(r=0.174,P=0.01),and personal resourcefulness score(r=0.219,P=0.001).Patients who living in cities,a household per capita monthly income above ￥ 3000,high school/technical secondary school or above education,brain work,disease duration ≤6 months,and cardiovascular hospitalization<3 times,reported higher scores for resourcefulness and personal resourcefulness than those living in rural areas,a household per capita monthly income under￥3000,junior high school or below education,physical work and retirement/unemployment,disease duration>6 months,and cardiovascular hospitalization≥3 times(all P<0.05);Patients who were married/cohabited,lived with family members,a household per capita monthly income above ￥ 3000,and cardiovascular hospitalization≥3 times reported higher scores for social resourcefulness than those who were single(unmarried/divorced/widowed),lived alone,a household per capita monthly income under ￥ 3000,and cardiovascular hospitalization<3 times(all P<0.05).3.Correlations between physiological,situational,and psychological factors and resourcefulness scores in patients with chronic heart failure3.1 Physiological factorsThe mean score for physical symptoms in patients with chronic heart failure was(22.45± 12.11),which was negatively correlated with the score for resourcefulness(r=-0.193,P=0.004)and the score for personal resourcefulness(r=-0.208,P=0.002).There was no correlation between physical symptoms and the score for social resourcefulness(r=-0.097,P=0.154).3.2 Situational factorsThe mean score for social network in patients with chronic heart failure was(16.69 ±4.23),which was positively correlated with the score for resourcefulness(r=0.606,P<0.001),the score for personal resourcefulness(r=0.521,P<0.001),and the score for social resourcefulness(r=0.497,P<0.001).The mean score for social support in patients with chronic heart failure was(60.28±9.20),which was positively correlated with the score for resourcefulness(r=0.667,P<0.001),the score for personal resourcefulness(r=0.534,P<0.001),and the score for social resourcefulness(r=0.606,P<0.001).3.3 Psychological factorsThe mean score for adaptive cognitive emotion regulation strategy in patients with chronic heart failure was(59.64±9.12),which was positively correlated with the score for resourcefulness(r=0.403,P<0.001),the score for personal resourcefulness(r=0.413,P<0.001),and the score for social resourcefulness(r=0.231,P=0.001).The mean score for personal mastery in chronic heart failure patients was(25.10±3.56),which was positively correlated with the score for resourcefulness(r=0.517,P<0.001),the score for personal resourcefulness(r=0.485,P<0.001),and the score for social resourcefulness(r=0.364,P<0.001).4.Multiple linear regression analysis of resourcefulness in patients with chronic heart failureEducational level,social network,social support,adaptive cognitive emotion regulation strategy and personal mastery were the positive influencing factors of resourcefulness in patients with chronic heart failure,while physical symptoms were negative influencing factors.Six variables accounted for 57.2%of the variance in the score for resourcefulness.Educational level,social support,adaptive cognitive emotion regulation strategy and personal mastery were the positive influencing factors of personal resourcefulness in patients with chronic heart failure,while physical symptoms were negative influencing factors.Five variables accounted for 51.7%of the variance in the score for personal resourcefulness.Marital status,social network and social support were the positive influencing factors of social resourcefulness in patients with chronic heart failure.Three variables accounted for 37.9%of the variance in the score for social resourcefulness.5.Network analysis of resourcefulness in patients with chronic heart failurePersonal resourcefulness score,social resourcefulness score and significant factors analyzed by multiple linear regression were used as network nodes to build the network graph.Results showed educational level(junior college and above:cs=0.69,high school or technical secondary school:cs=0.33),adaptive cognitive emotion regulation strategy(cs=0.21),personal mastery(cs=0.18),social network(cs=0.15),social support(cs=0.14)and physical symptoms(cs=0.12)were all directly correlated with personal resourcefulness.Marital status(cs=0.15),social support(cs=0.35)and social network(cs=0.12)were directly correlated with social resourcefulness.Conclusions:1.The resourcefulness of patients with chronic heart failure is at a moderate level partly lower,and the level of social resourcefulness is higher than personal resourcefulness.It is suggested that medical staff should timely evaluate the resourcefulness in patients with heart failure,especially focused on patients with low education level.2.The influencing factors of resourcefulness in patients with chronic heart failure were physical symptoms,social network,social support,adaptive cognitive emotion regulation strategy and personal mastery.It is suggested that the medical staff could improve the resourcefulness in patients with heart failure by alleviating their physical symptoms,improving their social network,increasing the social support,guiding them to use adaptive cognitive emotion regulation strategy frequently,and improving their personal mastery.3.Physiological,situational,and psychological factors are associated with resourcefulness in patients with chronic heart failure.The personal resourcefulness is more likely to be affected by adaptive cognitive emotion regulation strategy,and the social resourcefulness is more likely to be affected by social support.This suggests that medical staff can take the above factors as the core intervention targets,and take targeted interventions to improve the resourcefulness in patients with chronic heart failure. |
