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目的 探讨老年冠心病患者经皮冠状动脉介入治疗(percutaneous coronary intervention, PCI)术后康复锻炼依从性水平及其与锻炼行为感知(益处感知和障碍感知)之间的差异性特征。方法 本研究为横断面设计。采用便利抽样法选取2023年6月—2024年4月某三甲医院心血管内科收治的PCI手术1个月以上的老年冠心病患者为研究对象，采用一般资料调查表、运动依从性问卷、锻炼益处及障碍量表(exercise benefits/barriers scale, EBBS),对患者进行调查，分析患者康复锻炼依从性与锻炼行为感知的差异。结果 共调查273例老年冠心病，患者PCI术后康复锻炼依从性得分为(30.29±5.71)分，处于中等水平，其中高依从性组80例(占29.30%),低依从性组193例(占70.70%);锻炼行为感知经潜在剖面分析，划分为3组即低益处-高障碍型78例、感知均衡型128例、高益处-低障碍型67例，其中低依从性组低益外-高障碍型59例，占30.57%,高依从性组低益外-高障碍型19例，占23.75%;高依从性组与低依从性组患者的锻炼行为感知类型差异无统计学意义(χ2=3.081,P=0.214)。多元线性回归分析显示，年龄、文化程度、运动习惯、恐动症能够独立预测康复锻炼依从性(P<0.05);年龄、合并症个数、运动习惯、恐动症能够独立预测锻炼行为感知(P<0.05);主要差异为文化程度仅与锻炼依从性有关，而合并症个数仅与锻炼行为感知有关。结论 老年冠心病患者PCI术后康复锻炼依从性处于中等水平，患者对锻炼行为存在锻炼获益感知不足和锻炼障碍感知过度。提示医护人员应探究锻炼行为益处及障碍感知对锻炼依从性的影响机制，以制定针对性的干预措施，激发其参与术后持续性康复锻炼的内驱力。
Abstract：Objective Exploring the level of rehabilitation exercise adherence and its association with perceived exercise behavior(benefits and barriers perceptions) in elderly patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods This study adopted a cross-sectional design. The elderly patients with coronary heart disease who had undergone PCI surgery for more than a month and were admitted to the cardiovascular department of a tertiary hospital from June 2023 to April 2024 were selected as the research subjects by convenience sampling method, and were investigated by a general information survey form, exercise adherence questionnaire, and the exercise benefits/barriers scale(EBBS), and the difference in exercise adherence and perception of exercise behavior among the patients were analyzed. Results A total of 273 elderly patients with coronary heart disease were investigated. The compliance score of postoperative rehabilitation exercise for patients after PCI was(30.29±5.71) points, which was at a relatively moderate level. Among them, there were 80 cases(29.30%) in the high compliance group and 193 cases(70.70%) in the low compliance group; According to the potential profile analysis of exercise behavior perception, it was divided into 3 groups: 78 cases of low benefit-high obstacle type, 128 cases of perception balance type, and 67 cases of high benefit-low obstacle type. Among them, 59 cases in the low compliance group had low benefit-high obstacle type, accounting for 30.57%, and 19 cases in the high compliance group had high benefit-low obstacle type, accounting for 23.75%; There was no significant difference in the perceived types of exercise behavior between the high compliance group and the low compliance group(χ2=3.081,P=0.214). Multiple linear regression analysis showed that age, educational level, exercise habits, and phobias can independently predict rehabilitation exercise compliance(P<0.05); Age, number of comorbidities, esercise habits, and phobias could independently predict perceived exercise behavior(P<0.05); The main difference was that educational level was only related to exercise compliance, while the number of comorbidities was only related to perceived exercise behavior. Conclusion The adherence to rehabilitation exercises in elderly patients with coronary heart disease after PCI is at a moderate level, and patients have the insufficient perception of exercise benefits and excessive perception of exercise barriers. It is suggested that health care professionals should explore the impact mechanism of perceived benefits and barriers of exercise behaviors on exercise compliance, so as to establish targeted intervention measures, and stimulate their internal drive to engage in sustained postoperative rehabilitation exercises.
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基本信息:
DOI：10.16821/j.cnki.hsjx.2025.14.002
中图分类号:R473.5
引用信息:
[1]刘梦坛,高文君,周丹.老年冠心病患者经皮冠状动脉介入术后康复锻炼依从性与锻炼行为感知的差异性研究[J].护士进修杂志,2025,40(14):1462-1469.DOI:10.16821/j.cnki.hsjx.2025.14.002.
基金信息: