| Objectives:Through the nutritional risk assessment and in-depth interviews of inpatients with chronic heart failure in the cardiology department of a hospital in Jilin Province,the impact of nutritional risks on patients with heart failure was analyzed,and patients’ experience and cognition of nutritional risks were further explored,so as to develop individualization for patients with chronic heart failure.Provide a basis for targeted nutrition intervention programs.Methods:In this study,the convenient sampling method was used to select a total of 98 hospitalized patients with chronic heart failure.According to the inclusion and exclusion criteria,the patients will be screened to determine whether there is a nutritional risk according to the nutritional risk screening of the micro-nutrition evaluation method.The differences in general data,physical composition,4-meter walk test,medication,laboratory and imaging examinations,circumference and grip strength of patients with chronic heart failure were compared;the multivariate Logistic regression method was used to analyze the independent risk factors of nutritional risk.Afterwards,15 cases were enrolled in one-to-half structured interviews for patients with nutritional risk of chronic heart failure using the largest difference objective sampling method.Results:(1)In the general data analysis,a total of 98 subjects were included in this study,including 79 males(80.6%)and 19 females(19.4%).The results of general data show that in terms of age composition,the average age of inpatients with heart failure is(54.91±12.64)years old,the oldest is 81 years old,and the youngest is 20 years old;29 people(29.6%)with hypertension,15 people with diabetes(15.3%),2 people(2.0%)with kidney disease,1person(1.0%)with atrial fibrillation,33 people who smoke(33.7%),15 people who drink alcohol(15.3%),and 76 people(77.6%)who are at risk of nutrition.(2)General information The results of nutritional risk analysis showed that the age of hospitalized patients with heart failure with or without nutritional risk(P=0.023)was different,and the difference was statistically significant.(3)The body composition of chronic heart failure patients with nutritional risk showing height(P=0.003),weight(P=0.001),BMI(P<0.001),RASM(P=0.012),fat weight(P<0.001),fat mass index(P=0.003),total body fluid(P<0.001),extracellular fluid(P<0.001),visceral fat(P=0.001)and other indicators are lower than patients with chronic heart failure without nutritional risk,and there is statistical significance.(4)The 4-meter walking experiment showed that the 4-meter walking time of patients with nutritional risk of chronic heart failure(P=0.007)was higher than that of patients with no nutritional risk of chronic heart failure,and the 4-meter walking speed of patients with nutritional risk of chronic heart failure(P=0.007)was lower There is statistical significance in patients with chronic heart failure without nutritional risk.(5)The results of medication analysis showed that there was statistical significance in the use of furosemide(P=0.033)and spironolactone(P=0.026)in patients with chronic heart failure with or without nutritional risk.(6)Laboratory and imaging examinations showed that the left ventricular diastolic diameter LVEDd(P=0.03)of chronic heart failure patients with nutritional risk was higher than that of patients with chronic heart failure without nutritional risk,which was statistically significant.(7)Circumference and grip strength showed that the left arm circumference(P<0.001),right arm circumference(P<0.001),left thigh circumference(P=0.005),right thigh circumference(P=0.004),left arm circumference(P<0.001),left thigh circumference(P=0.004),left arm circumference of patients with chronic heart failure at nutritional risk Calf circumference(P=0.005),waist circumference(P<0.001),hip circumference(P<0.001),grip strength(P=0.003)and other indicators were lower than those of patients with chronic heart failure without nutritional risk,and there was statistical significance.(8)The results of multivariate logistic regression analysis are: the OR values of body weight and 4-meter walking time are 0.931 and 1.996,respectively.(9)Through in-depth analysis of the interview data,the researchers finally got four themes: misunderstanding of nutritional risk;insufficient awareness of the relationship between nutritional risk and heart failure;multiple factors affecting nutritional risk;passive acceptance of improvement,and strengthening of nutrition-related education.Conclusion:(1)The incidence of nutritional risk in hospitalized patients with chronic heart failure is higher,which is 67.86%.Early identification of patients with nutritional risk and early reasonable nutritional intervention can improve the nutritional status of patients and avoid further severe nutritional deficiencies.(2)The risk factors for nutritional risk in hospitalized patients with chronic heart failure include age,RASM,fat weight,fat mass index,total body fluid,extracellular fluid,visceral fat,4-meter walking time,4-meter walking speed,furosemide,spironolactone,LVEDd,Grip strength,in which 4 meters walking time is an independent risk factor for the nutritional risk of patients with chronic heart failure.The longer the 4-meter walk,the more likely it is to cause nutritional risks.(3)Inpatients with chronic heart failure have misunderstandings and insufficient understanding of nutritional risks,and the relationship between nutritional risks and heart failure is vague.There are cases of passive acceptance of improvement.It is necessary to strengthen education and education related to nutrition risk care and provide personalized intervention programs according to the specific conditions of patients. |
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