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主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
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中国护理管理 ›› 2025, Vol. 25 ›› Issue (1): 37-41.doi: 10.3969/j.issn.1672-1756.2025.01.008

• 论著 • 上一篇    下一篇

老年慢性心力衰竭患者症状群及桥梁症状网络分析

李如如 王苗 陈硕硕 徐嘉仪 王珏 韩亚茹 张丽青   

  1. 温州医科大学第一临床医学院,325000 浙江省温州市(李如如,陈硕硕,徐嘉仪);温州医科大学慈溪生物医药研究院(王苗);温州医科大学附属第一医院心脏外科(王珏);医院感染管理处(张丽青);温州医科大学护理学院(韩亚茹)
  • 出版日期:2025-01-15 发布日期:2025-01-15
  • 通讯作者: 张丽青,本科,主任护师,E-mail:1390406419@qq.com
  • 作者简介:李如如,硕士在读
  • 基金资助:
    温州市科技局项目(Y20210077)

Network analysis of symptom clusters and bridge symptoms in elderly with chronic heart failure

LI Ruru, WANG Miao, CHEN Shuoshuo, XU Jiayi, WANG Jue, HAN Yaru, ZHANG Liqing   

  1. The First School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang province, 325000, China
  • Online:2025-01-15 Published:2025-01-15
  • Contact: E-mail:1390406419@qq.com

摘要: 目的:识别老年慢性心力衰竭患者症状群及其桥梁症状,为患者症状管理提供依据。方法:采用便利抽样法,选取温州市2家三级甲等医院老年慢性心力衰竭患者252例为研究对象,采用中文版Memorial心力衰竭症状评估量表进行调查,通过因子分析提取症状群,网络分析识别症状群结构和桥梁症状。结果:共提取出呼吸-睡眠障碍症状群、外周水肿症状群、头晕-疲乏症状群、口咽不适症状群4个症状群,桥梁强度前4位的症状分别为腿部或手臂水肿(rS=0.559,rE=3.756)、平躺时呼吸困难(rS=0.408,rE=4.556)、缺乏食欲(rS=0.396,rE=3.999)、口干(rS=0.363,rE=2.199),预期影响最高的症状是夜间睡眠憋醒(rE=4.750,rS=0.202)。结论:腿部或手臂水肿是老年慢性心力衰竭患者核心桥梁症状,夜间睡眠憋醒、平躺时呼吸困难、缺乏食欲以及口干是连接不同症状群的桥梁症状。借助桥梁症状在各个症状群间的桥接作用,对桥梁症状实施护理干预措施,能在一定程度上提高症状管理效率。

关键词: 老年;慢性心力衰竭;症状群;桥梁症状;网络分析

Abstract: Objective: To identify symptom clusters in elderly patients with chronic heart failure, explore the relationships among symptoms within these clusters, and identify the bridge symptoms. Methods: Convenience sampling was employed to select 252 elderly patients with chronic heart failure from two hospitals in Wenzhou. A questionnaire survey was conducted using the Memorial Symptom Assessment Scale-Heart Failure. Symptom clusters were identified through exploratory factor analysis, and network analysis was used to identify the bridge symptoms among these clusters. Results: We identified 4 symptom clusters: respiratory sleep disorder, peripheral edema, dizziness and fatigue, and oropharyngeal discomfort. The top four bridge symptoms were swelling in the legs or arms (rS=0.559, rE=3.756), difficulty breathing when lying flat (rS=0.408, rE=4.556), loss of appetite (rS=0.396, rE=3.999), and dry mouth (rS=0.363, rE=2.199). The symptom expected to have the greatest impact was waking up with shortness of breath at night (rE=4.750, rS=0.202). Conclusion: Swelling in the legs or arms serves as the core bridge symptom in elderly patients with chronic heart failure. Waking up with shortness of breath at night, difficulty breathing when lying flat, loss of appetite, and dry mouth act as bridge symptoms connecting symptom clusters. Targeted interventions for these bridge symptoms, based on their bridging roles among different symptom clusters, have the potential to enhance the effectiveness of symptom management to a certain degree.

Key words: aged; chronic heart failure; symptom cluster; bridge symptom; network analysis

中图分类号:  R47;R197