| ObjectiveThis study aims to understand the status of activities of daily living in elderly patients with coronary heart disease and chronic heart failure,analyze the main influencing factors of the activities of daily living,and put forward measures and suggestions for preventing or reducing the decline in the activities of daily living in elderly patients with coronary heart disease and chronic heart failure.It provides a theoretical basis for formulating rehabilitation exercise programs and interventions to improve the prognosis of the disease.MethodsA cross-sectional study method was used to select 495 elderly patients with coronary heart disease and chronic heart failure over 60 years old in the Department of Cardiovascular medicine A and B wards in a tertiary hospital of Qingdao from December 2016 to November 2017.The contents of the questionnaire included:general demographic characteristics questionnaire,Activities of Daily Living(ADL),Chronic disease questionnaire,Social Support Rating Scale(SSRS),Geriatric Depression Scale-15(GDS-15).SPSS 22.0 statistical analysis software was used for data analysis,and the frequency and percentage were used to describe the general data of elderly patients;the chi-square test was used to perform univariate analysis of physical self-maintenance,instrumental activities of daily living,and total activities of daily living of elderly patients with coronary heart disease and chronic heart failure;t-test was used to analyze the influence of social support on the activities of daily living;logistic regression analysis was used to analyze multivariate analysis of influencing factors such as physical self-maintenance,instrumental activities of daily living and total activities of daily living.P < 0.05 was considered statistically significant.Results1.The status of activities of daily living of elderly patients with coronary heart disease and chronic heart failure: The decline rate of activities of daily living was 76.6%,impaired function accounting for 42.6%,dysfunction accounting for 34.0%.Instrumental activities of daily living(IADL)declined mainly.The decline rate of "washing clothes" was the highest and "taking medicine" was the lowest.The decline rate of physical self-maintenance(PSMS)was 43.2%.The highest decline rate is "bathing",and the lowest drop rate is "toilet".2.Univariate analysis of the activities of daily living of elderly patients with coronary heart disease and chronic heart failure:(1)PSMS: the rate of PSMS between different groups was statistically significant in different age,educational level,marital status,average monthly income,daily medication type,NYHA classification,course of disease,the number of falls within one year,the number of hospitalization within six months,the number of chronic diseases,exercise,depression,different social support conditions in elderly patients with coronary heart disease and chronic heart failure(P<0.05).(2)IADL: the rate of decline in IADL between different groups was statistically significant in different ages,sex,educational level,marital status,average monthly income,daily medication type,NYHA classification,course of disease,the number of falls within one year,the number of hospitalization within six months,the number of chronic diseases,exercise,depression and different social support conditions in elderly patients with coronary heart disease and chronic heart failure(P<0.05).(3)ADL: the rate of decline in ADL between different groups was statistically significant in different age,sex,educational level,marital status,average monthly income,daily medication type,NYHA classification,course of disease,the number of falls within one year,the number of hospitalization within six months,the number of chronic diseases,exercise,depression,and different social support conditions in elderly patients of elderly patients with coronary heart disease in association with chronic heart failure(P<0.05).3.Binary logistic regression analysis of activities of daily living of elderly patients with coronary heart disease in association with chronic heart failure(1)PSMS:Average monthly income more than 1000,exercise and subjective support are the protective factors for the decline in physical self-maintenance.Age more than 70 years old,NYHA classification III and IV,disease duration more than 5 years,falls occurred within 1 year,more than two times hospitalizations within 6 months,depression are risk factors for the decline in physical self-maintenance.(2)IADL: Average monthly income more than 1000 yuan,exercise,subjective support and objective support are protective factors for the decline in IADL.Age more than 70 years old,NYHA class II-IV,disease duration more than 5 years,and falls occurred within 1 year,more than one time hospitalizations within six months,combined with 3 or more chronic diseases and depression were risk factors for the decline in IADL.(3)Total ADL: High school and above educational level,average monthly income more than 1000 yuan,exercise and subjective support are protective factors for total ADL decline.Age more than 70 years old,NYHA class II-IV,disease duration more than 5 years,falls occurred within one year,hospitalization more than one time within six months,combined with 3 or more chronic diseases and depression are risk factors for the decline of total ADL.ConclusionThe elderly patients with coronary heart disease and chronic heart failure have poorer activities of daily living and relate to age,educational level,average monthly income,NYHA heart function classification,course of disease,number of falls within one year,number of hospitalization within six months,number of chronic diseases,exercise,subjective support,objective support,depression.Medical staff should develop effective rehabilitation programs and interventions for these factors,so as to reduce the decreasing rate of activities of daily living and improve the quality of life in elderly patients,achieve the purpose of preventing disability. |
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