Investigation of Health Needs and Analysis of Influencing Factors in Patients Who have Returned to Work after Myocardial Infarction

doi:10.3969/j.issn.1007-9572.2018.00.247

Abstract

Abstract: Background　At present，there are about 2.5 million patients with myocardial infarction in China.In the next 15 years，75 million more patients with myocardial infarction are expected.The prevalence of myocardial infarction is on the rise among young people，and most patients are the main component of social productivity.The ability to return to work is one of the indicators of recovery.However，the needs of disease management，disease prevention and work-related problems for patients with myocardial infarction after returning to work have not been met.As their coping ability is poor，patients may still encounter physical and mental problems.Objective　To understand the health needs of patients who have returned to work after experiencing myocardial infarction，and to analyze the factors influencing these needs，to provide a reference for relevant intervention research.Methods　A questionnaire survey was conducted through a convenient sampling method，in patients with myocardial infarction who had returned to work within 2 years after discharge from three Third Grade-associated ＆ Class hospitals in Zhengzhou City between June 2017 and October 2017.The general information and health needs of the participants were surveyed，including their need for guidance regarding disease-related knowledge，medication guidance，dietary guidance，exercise and activity guidance，lifestyle guidance，psychological counseling and the work-associated.Results　A total of 340 questionnaires were distributed，and 326 valid questionnaires were returned.The effective recovery rate was 95.9%.The total score of the health needs was （130.4±8.7）；the disease-related knowledge dimension score was （4.1±0.3）；the medication guidance dimension score was （3.2±0.6）；the dietary guidance dimension score was （3.1±0.7）；the exercise and activity guidance dimension score was （3.1±0.7）；the lifestyle guidance dimension score was （3.3±0.7）；the psychological counseling dimension score was （3.5±0.6）；and the work-associated dimension score was （3.8±0.5）.There were significant differences in education level，family monthly income，time before return to work，number of disease complications，and number of stents installed（P<0.05）.Multiple linear regression analysis showed that the education level（β=4.222），time before return to work（β=-1.832），number of disease complications（β=1.635），and number of stents installed（β=2.573） were factors that affected the health needs of the participants （P<0.05）.Conclusion　Although patients with myocardial infarction recovered and returned to work，they still had a high degree of health needs.Targeted education and guidance should be carried out according to the specific needs of patients to improve the health conditions and quality of life of these patients.

Key words: Myocardial infarction, Health needs, Return to work, Root cause analysis

摘要： 背景　目前我国心肌梗死患者约250万。未来15年内，预计将增加7 500万例心肌梗死患者。心肌梗死的患病率在年轻人中呈上升趋势，大多数患者是社会生产力的主要组成部分。重返工作是疾病康复的衡量指标之一，但重返工作后心肌梗死患者在疾病管理、预防及工作相关的需求并未满足，患者应对能力较差，身心问题仍然存在。目的　了解重返工作后心肌梗死患者的健康需求并分析其影响因素，为相关干预性研究提供依据。方法　采用方便抽样的方法，于2017年6—10月对郑州市某三所三级甲等医院心脏科出院后2年内已重返工作的心肌梗死患者进行问卷调查。调查其一般资料及健康需求状况，包括疾病相关知识、用药指导、饮食指导、运动及活动指导、生活方式指导、心理疏导和工作中的需求。结果　共发放问卷340份，回收有效问卷326份，有效回收率为95.9%。患者健康需求得分为（130.4±8.7）分，疾病相关知识维度得分为（4.1±0.3）分，用药指导维度得分为（3.2±0.6）分，饮食指导维度得分为（3.1±0.7）分，运动及活动指导维度得分为（3.1±0.7）分，生活方式指导维度得分为（3.3±0.7）分，心理疏导维度得分为（3.5±0.6）分，工作中的需求维度得分为（3.8±0.5）分。不同文化程度、家庭月收入、重返工作时间、合并疾病数量和安装支架个数者健康需求得分比较，差异均有统计学意义（P<0.05）。多元线性回归分析结果显示，文化程度（β=4.222）、重返工作时间（β=-1.832）、合并疾病数量（β=1.635）、安装支架个数（β=2.573）是影响重返工作心肌梗死患者健康需求的因素（P<0.05）。结论　心肌梗死患者经过康复虽已重返工作，在适应疾病后工作、生活的过程中健康需求程度仍较高，应根据患者的具体需求开展针对性教育和指导，提高重返工作后心肌梗死患者的健康状况和生活质量，从而帮助患者更好地回归社会。

关键词: 心肌梗死, 健康需求, 重返工作, 影响因素分析

DU Ruofei,WANG Panpan,CHEN Changying. Investigation of Health Needs and Analysis of Influencing Factors in Patients Who have Returned to Work after Myocardial Infarction[J]. Chinese General Practice, 2019, 22(5): 586-590. DOI: 10.3969/j.issn.1007-9572.2018.00.247.
杜若飞,王盼盼,陈长英. 重返工作后心肌梗死患者健康需求及影响因素研究[J]. 中国全科医学, 2019, 22(5): 586-590. DOI: 10.3969/j.issn.1007-9572.2018.00.247.

References

［1］中国心血管病报告编写组.《中国心血管病报告2016》概要［J］．中国循环杂志，2017，32（6）：521-530．
Chinese Cardiology Report Group.Chinese cardiovascular disease report 2016［J］．Chinese Circulation Journal，2017，32（6）：521-530．
［2］STEVENS W，PENRVA D，LI J Z，et al．Estimating the future burden of cardiovascular disease and the value of lipid and blood pressure control therapies in China［J］．BMC Health Serv Res，2016，16（1）：175-184．DOI：10.1186/s12913-016-1420-8.
［3］MIRMOHAMMADI S J，SADRBAFGHI S M，MEHRPARVAR A H，et al．Evaluation of the return to work and its duration after myocardial infarction［J］．ARYA Atheroscler，2014，10（3）：137-140.
［4］MEHRDAD R，GHADIRI A N，POURYAGHOUB G，et al．Predictors of early return to work after a coronary artery bypass graft surgery（CABG）［J］．Int J Occup Med Environ Health，2016，29（6）：947-957．DOI：10.13075/ijomeh.1896.00798.
［5］BENSHALOM Y.Assessing the costs and benefits of return-to-work programs（issue brief）［J］．Mathematica Policy Research Reports，2015，317（5841）：356-359.
［6］LAMBERTI M，RATTI G，GERARDI D，et al．Work-related outcome after acute coronary syndrome：implications of complex cardiac rehabilitation in occupational medicine［J］．Int J Occup Environ Med，2016，29（4）：649-657．
［7］BABIC Z，PAVLOV M，O?TRIC M，et al．Re-initiating professional working activity after myocardial infarction in primary percutaneous coronary intervention networks era［J］．Int J Occup Med Environ Health，2015，28（6）：999-1010．
［8］BIERING K，LUND T，ANDERSEN J H，et al．Effect of psychosocial work environment on sickness absence among patients treated for ischemic heart disease［J］．J Occup Rehabil，2015，25（4）：776-782．DOI：10.1007/s10926-015-9587-0.
［9］于永中，李天麟.GB3869-83 中华人民共和国国家标准体力劳动强度分级［J］．化工劳动保护，1999（s3）：15-16.
YU Y Z，LI T L.National standard physical labor intensity classification of People's Republic of China［J］．Chemical Industry Occupational Safety ＆ Health，1999（s3）：15-16.
［10］徐勤勤，单伟超，王颖，等．心肌梗死患者延续期护理知识需求问卷的编制［J］．中华现代护理杂志，2016，22（10）：1392-1395．DOI：10.3760/cma.j.issn.1674-2907.2016.10.016.XU Q Q，SHAN W C，WANG Y，et al．Development of duration knowledge requirement questionnaire of myocardial infarction patients［J］．Chinese Journal of Modern Nursing，2016，22（10）：1392-1395．DOI：10.3760/cma.j.issn.1674-2907.2016.10.016.
［11］BYRNE R A，JONER M，KASTRATI A.Stent thrombosis and restenosis：what have we learned and where are we going？The Andreas Grüntzig Lecture ESC 2014［J］．Eur Heart J，2015，36（47）：3320-3331．DOI：10.1093/eurheartj/ehv511.
［12］DAMEN N L，VERSTEEG H，BOERSMA E，et al．Depression is independently associated with 7-year mortality in patients treated with percutaneous coronary intervention：results from the research registry［J］．Int J Cardiol，2013，167（6）：2496-2501．
［13］胡晓林，游桂英，李继平.冠心病病人行冠状动脉介入治疗的健康教育需求分析［J］．护理研究，2012，26（19）：1751-1753．DOI：10.3969/j.issn.1009-6493.2012.19.010.
HU X L，YOU G Y，LI J P.Analysis on health education demand of patients with coronary heart disease accepting interventional procedures［J］．Chinese Nursing Research，2012，26（19）：1751-1753．DOI：10.3969/j.issn.1009-6493.2012.19.010.
［14］MOSLEH S M，ESHAH N F，ALMALIK M M.Perceived learning needs according to patients who have undergone major coronary interventions and their nurses［J］．J Clin Nurs，2017，26（3/4）：418-426.
［15］徐勤勤，单伟颖，王颖，等．心肌梗死患者延续性护理知识需求及影响因素分析［J］．广东医学，2016，37（13）：1999-2002.
［16］GHISI G L，GRACE S L，THOMAS S，et al．Development and psychometric validation of a scale to assess information needs in cardiac rehabilitation：the INCR tool［J］．Patient Education & Counseling，2013，91（3）：337-343.
［17］陈晨，刘美丽，胡经文，等．陕西某三甲医院721例冠心病患者延续护理服务需求调查研究［J］．中华现代护理杂志，2017，23（3）：376-382．
CHEN C，LIU M L，HU J W，et al．Demand of 721 patients with CHD for transitional care service in a tertiary hospital of Shaanxi［J］．Chinese Journal of Modern Nursing，2017，23（3）：376-382．
［18］MAJEED S M A，SAMS L M，MARIA C，et al．Assessment of information needs among patient with myocardial infarction in tertiary care hospital in mangalore［J］．Indian Journal of Public Health Research & Development，2015，6（3）：58-62.
［19］ALFASFOS N，DARAWAD M W，NOFAL B，et al．Knowledge，attitudes，beliefs and perceived risk of acute coronary syndrome among Jordanian patients［J］．Health，2016，8（8）：1830-1844.
［20］梁宝凤，和霞，林梅.急性冠脉综合征患者延续性护理需求调查分析［J］．天津护理，2016，24（1）：17-19．
LIANG B F，HE X，LIN M.A survey and analysis of demand of continuing nursing care for acute coronary syndrome patients［J］．Tianjin Journal of Nursing，2016，24（1）：17-19．

[1]	QIN Fengyin, ZHANG Qishan, LAI Jinjia, HUANG Yimin, HAN Guoyin, SUN Xinglan, WANG Fen, TAN Yibing. Current Status and Influencing Factors of the Intention to Screen for High-risk Stroke among Community Residents in Guangdong [J]. Chinese General Practice, 2023, 26(34): 4283-4289.
[2]	HAO Aihua, ZENG Weilin, LI Guanhai, XIA Yinghua, CHEN Liang. Current Situation of the Construction of Family Doctor Team: an Investigation Based on the Perspective of General Practitioners [J]. Chinese General Practice, 2023, 26(34): 4261-4268.
[3]	LI Dianjiang, PAN Enchun, SUN Zhongming, WEN Jinbo, WANG Miaomiao, WU Ming, SHEN Chong. The Current Status and Influencing Factors of Clinical Inertia in Type 2 Diabetes Patients in Community [J]. Chinese General Practice, 2023, 26(34): 4296-4301.
[4]	WANG Yue, CHEN Qing, LIU Lurong. Detection Rate of Depression and Its Influencing Factors in Chinese Elderly: a Meta-analysis [J]. Chinese General Practice, 2023, 26(34): 4329-4335.
[5]	WANG Yu, CHEN Yan, HAN Yuanyuan, XU Qing, CHEN Shengyue, LYU Zhibo, LU Chuan, ZHENG Mingxin, ZHAO Xin. Platelet-lymphocyte Ratio Predicts In-hospital Mortality in Elderly Patients with Acute Myocardial Infarction [J]. Chinese General Practice, 2023, 26(33): 4137-4142.
[6]	WANG Lina, GAO Pengfei, CAO Fan, GE Ying, YAN Wei, HE Daikun. Analysis of the Prevalence and Influencing Factors of Non-alcoholic Fatty Liver Disease in Different Gender Groups [J]. Chinese General Practice, 2023, 26(33): 4143-4151.
[7]	LIANG Xuan, NA Feiyang, QIN Mengyao, YANG Hui, GUO Li, GUO Qi, REN Lei, CHEN De, LIU Donghai, ZHANG Rongfang. Clinical Characteristics and Influencing Factors of Bronchial Asthma Combined with Obstructive Sleep Apnea-hypopnea Syndrome in Children [J]. Chinese General Practice, 2023, 26(33): 4225-4230.
[8]	LI Qianqian, CHEN Xunrui, ZHANG Wenying, YUAN Haihua, ZHANG Yanjie, JIANG Bin, LIU Feng. Demand and Influencing Factors for Community Health Services during Chemotherapy of Patients with Advanced Cancer [J]. Chinese General Practice, 2023, 26(33): 4173-4180.
[9]	ZHANG Jin, DING Zhiguo, QI Shuo, LI Ying, LI Weiqiang, ZHANG Yuanyuan, ZHOU Tong. Relationship between Serum Thyroid Hormone Levels and Prognosis during Hospitalization in Heart Failure Patients [J]. Chinese General Practice, 2023, 26(33): 4125-4129.
[10]	ZHOU Yuyu, GAO Chuan, CUI Puan, WANG Yaping, HE Zhong. Influencing Factors of Shared Decision Making between Doctors and Patients in Menopausal Hormone Therapy in Patients with Menopausal Syndrome [J]. Chinese General Practice, 2023, 26(33): 4181-4186.
[11]	GAO Dekang, WEI Shaohua, MA Xiaoming, DU Peng, XING Chungen, CAO Chun. Risk Factors for Loss of Skeletal Muscle Mass and Its Correlation with Complications after Major Hepatectomy for Liver Cancer [J]. Chinese General Practice, 2023, 26(32): 4031-4037.
[12]	ZHANG Juan, LI Haifen, LI Xiaoman, YAO Miao, MA Huizhen, MA Qiang. Construction of Recurrence Risk Prediction Model for Diabetic Foot Ulcer on the Basis of Logistic Regression, Support Vector Machine and BP Neural Network Model [J]. Chinese General Practice, 2023, 26(32): 4013-4019.
[13]	GAO Jing, ZHOU Shangcheng, GAO Sande, ZOU Guanyang, CHEN Yingyao. Health-related Quality of Life and Its Influencing Factors in Patients with Prevention of Disease in Traditionnal Chinese Medicine based on EQ-5D-5L Scale [J]. Chinese General Practice, 2023, 26(32): 4043-4050.
[14]	WANG Minghuan, LI Yuhong, YU Min, WANG Yougang, YU Qiaozhi, YANG Fangfang, YUAN Dehui, ZHANG Liu. Effect of Allostatic Load on Adverse Pregnancy Outcomes of Women in Late Pregnancy [J]. Chinese General Practice, 2023, 26(32): 4064-4069.
[15]	YUAN Dehui, LI Yuhong, XIONG Min, YU Min, MA Ruiliang, YANG Fangfang, YU Qiaozhi, WANG Minghuan. Status and Influencing Factors of Allostatic Load in Pregnant Women at Different Trimesters [J]. Chinese General Practice, 2023, 26(32): 4057-4063.