杨晓玲,马 芳,刘琮琳

目的：系统分析冠心病患者运动恐惧的影响因素，为临床护理工作提供循证指导。方法：计算机检索CNKI、Cochrane Library、PubMed、CINAHL、Embase、万方数据库及中国生物医学文献数据库，系统搜集冠心病患者运动恐惧影响因素的相关文献，检索时间为从建库至2024年7月18日，按照纳入与排除标准筛选文献和提取资料，横断面研究采用AHRQ横断面研究质量评估量表进行质量评价,队列研究采用NOS量表进行质量评价，根据集合定性分析法对结论一致的影响因素进行合并分析。结果：本次研究共纳入19篇文献，其中16篇横断面研究、3篇纵向研究，总样本3384例，影响冠心病患者运动恐惧的主要因素包括：年龄、性别、受教育程度、植入支架个数、活动情况、病程、焦虑、运动自我效能。结论：冠心病患者运动恐惧的影响因素众多，医护人员应该尽早识别运动恐惧人群，及时采取干预措施，降低患者的运动恐惧水平。

冠心病；运动恐惧；影响因素；系统评价

[1] 2022年中国心血管病医疗质量概述[J].中国循环杂志,2023,05:482-495. [2] 李琪,朴京京,万博雅,闫灵君,谷岩梅.冠心病病人运动恐惧的评价与干预研究进展[J].护理研究,2023,37(2):269-272. [3] 黄森,苏迈,苏虹,等.运动对冠心病病人PCI术后心脏康复效果的影响[J].中西医结合心脑血管病杂志,2018,16(20);3004-3007. [4] 曾宪涛,刘慧,陈曦,等.Meta分析系列之四:观察性研究的质量评价工具[J].中国循证心血管医学杂志,2012,4(04):297-299. [5] 陈坤.临床科研设计[M].浙江大学出版社,2019. [6] 崔贵璞,雷梦杰.冠心病患者运动恐惧相关影响因素的研究[J].天津护理,2019,03:293-298. [7] 陈思杏,陈务贤,张玉秀,李枝秀,覃春雨,罗秋湖.中青年冠心病经皮冠状动脉介入术后处于长期康复期患者的恐动症现状及其影响因素分析[J].广西医学,2022,44(4):454-457. [8] 梁燕,张亮,付莹,肖杜娟,袁艳娟.冠心病PCI术后病人运动恐惧现状及其相关危险因素分析[J].全科护理,2022,20(30):4287-4289. [9] 刘婷阳,邓桂元,赖娟.冠心病支架植入术后患者运动恐惧调查及影响因素分析[J].齐鲁护理杂志,2020,26(8):109-112. [10] 宋晓梅,彭艳婷,安利杰,朱亚飞,马素慧,李淑杏.冠心病病人运动恐惧现状及影响因素分析[J].全科护理,2022,20(1):94-97. [11] 王晓旭,王芬,王毓,张彬,胡同秀,赵文文.经皮冠状动脉支架植入术后患者运动恐惧现状及其相关因素分析[J].济宁医学院学报,2021,44(1):30-34,39. [12] 郑宇娟,赵华,王晓云,郭明媚,侯永超,邢雁芬.冠心病患者经皮冠状动脉介入治疗术后运动恐惧现状及影响因素分析[J].山西医药杂志,2022,51(6):611-614. [13] Gołba A,Soral T,Młynarska A,Dzierzawa M,Kowalik-Kabat A,Dębska B,Kulesza P,Sanecki K,Pol-Romik J,Żurawski P,Pieczara M,Durmała J,Marcisz C,Gołba KS.[Kinesiophobia in patients with cardiovascular disease].Wiad Lek.2018;71(9):1653-1660. [14] 王颖,范佳薇,施小青,王朦,陆静,陆敏霞,刘琳,毛莉芬,秦淑文.急性心肌梗死患者运动恐惧水平及其影响因素的纵向研究[J].护理学杂志,2022,37(14):27-31 [15] Çakal B,Yıldırım M,Emren SV.Kinesiophobia,physical performance,and health-related quality of life in patients with coronary artery disease.Postepy Kardiol Interwencyjnej.2022;18(3):246-254. [16] Brunetti ND,Guerra A,Ieva R,et al.Scared for the scar:fearsome impact of acute cardiovascular disease on perceived kinesiophobia (fear of movement).Clin Cardiol.2017;40(7):480-484. [17] Bäck M,CiderÅ,Herlitz J,Lundberg M,Jansson B.The impact on kinesiophobia(fear of movement)by clinical variables for patients with coronary artery disease.Int J Cardiol.2013;167(2):391-397. [18] Farris SG,Abrantes AM,Bond DS,Stabile LM,Wu WC.Anxiety and Fear of Exercise in Cardiopulmonary Rehabilitation:PATIENT AND PRACTITIONER PERSPECTIVES.J Cardiopulm Rehabil Prev.2019;39(2):E9-E13. [19] Bäck M,Lundberg M,CiderÅ,Herlitz J,Jansson B.Relevance of Kinesiophobia in Relation to Changes Over Time Among Patients After an Acute Coronary Artery Disease Event.J Cardiopulm Rehabil Prev.2018;38(4):224-230. [20] Knapik A,Dąbek J,Brzęk A.Kinesiophobia as a Problem in Adherence to Physical Activity Recommendations in Elderly Polish Patients with Coronary Artery Disease.Patient Prefer Adherence.2019;13:2129-2135.Published 2019 Dec 16. [21] Keessen P,Kan KJ,Ter Riet G,et al.Impact of kinesiophobia on initiation of cardiac rehabilitation:a prospective cohort path analysis.BMJ Open.2022;12(11):e066435.Published 2022 Nov 25. [22] 刘静,赵晓莉,张彩丽.冠心病患者首次PCI术后出现运动恐惧的影响因素分析[J].黑龙江医药科学,2024,47(2):60-61,65. [23] 冯珊珊,王彩香,王波.冠状动脉支架植入术后患者运动恐惧现状及其影响因素分析[J].现代医药卫生,2024,40(11):1896-1899. [24] 宋健,陈瑆,刘洁.冠心病行PCI术后患者运动恐惧现状及影响因素[J].江苏卫生事业管理,2023,34(09):1308-1311. [25] Cai,L.et al.Incidence and risk factors of kinesiophobia afer total knee arthroplasty in Zhengzhou,China:A cross-sectional study. J.Arthroplasty.33(9),2858–2862(2018). [26] Pan,L.&Shi,B.Prevalence of kinesiophobia in patients with chronic low back pain and its infuential factors.Chin.Gen.Pract.08(22),978–982(2019) [27] Bäck M,CiderÅ,Herlitz J,Lundberg M,Jansson B.Kinesiophobia mediates the influences on attendance at exercise-based cardiac rehabilitation in patients with coronary artery disease.Physiother Theory Pract.2016;32(8):571-580. [28] 张晶,丁建玲,张家帅,陶秀秀,贲艳丽.冠状动脉旁路移植术患者运动恐惧现状及影响因素分析[J].中华护理杂志,2023, 58(10):1205-1211. [29] Jiang CH,Zhu F,Qin TT.Relationships between chronic diseases and depression among middle-aged and elderly people in China:a prospective study from CHARLS[J].Curr Med Sci,2020,40(5):858-870. [30] 王铁枫,刘雁峰,吴杨乔,等.心理应激因素与更年期综合征的相关性研究[J].中华中医药杂志,2020,35(7):3665-3669 [31] BALASH Y,KORCZYN A D,MIGIROV A A,et al.Quality of life in Parkinson's disease:a gender-specific perspective[J].Acta Neurol Scand,2019,140(1):17-22. [32] GEORGIEV D,HAMBERG K,HARIZ M,et al.Gender differences in Parkinson's disease:a clinical perspective[J].Acta Neurol Scand,2017,136(6):570-584. [33] CASALE R,ATZENI F,BAZZICHI L,et al.Pain in women:a perspective review on a relevant clinical issue that deserves prioritization[J].Pain Ther,2021,10(1):287-314. [35] 刘静,赵晓莉,张彩丽.冠心病患者首次PCI术后出现运动恐惧的影响因素分析[J].黑龙江医药科学,2024,47(02):60-61+65. [36] GHISI G L D M,BRITTO R,MOTAMEDI N,et al.Disease-related knowledge in cardiac rehabilitation enrollees:correlates and changes[J].Patient Education and Counseling,2015,98(4):533-539. [37] 周巧,颜笛玉.奥塔戈运动锻炼项目对跌倒恐惧老年患者的应用效果[J].中国临床护理,2021,13(01):30-31+35. [38] Charney DS,Deutch A.A functional neuroanatomy of anxiety and fear:implications for the pathophysiology and treatment of anxiety disorders.Crit Rev Neurobiol.1996;10(3-4):419-446. [39] 黄蓉,丁梅,黄华华,张华伟.运动自我效能在冠心病患者运动恐惧和体育活动量间的中介作用[J].中华护理教育,2022, 19(12):1119-1123.

点击下载PDF