Study On The Status Of Quality Of Life,Self-management And Readmission And Their Relationships In Patients With Atrial Fibrillation

Objective: The study was to explore the status of self-management and quality of life in patients with atrial fibrillation,to analyze the relationship among self-management,quality of life and readmission.Methods : Using the method of convenience sampling,615 patients meting the inclusion and exclusion criteria were recruited from December 2016 to October 2017 in seven hospitals.The patients filled out the self-made social-demographic and clinical characteristics,self-management ability ability and quality of life of questionnaire.The SPSS18.0 statistics analysis package was used to do the descriptive statistics,one-way analysis of variance,independent t-test and multifactor analysis.The Amos 22.0 was used to analyze the the relationship among self-management ability,quality of life and readmission.Results:(1)650 questionnaire were distributed and 615 of them were valid.The valid response rate was 94.62%.(2)The total score of quality of life in patients with atrial fibrillation was(45.84±13.34)and the scores of physioligical,psychological and sex dimension were(44.78±16.12),(42.34±18.98)and(54.05±17.39),respectively.The total scores of self-management ability in patients taken warfarin,aspirin and dabigatran were(71.77±12.80)and(69.33±12.31),respectively.The total score of patients which did not accept antithrombotic therapy was(66.71±11.59).The difference of self-management ability among them was significant(P<0.05).The times of hospitalizations of?1 and(29)1 were 511 patients(83.1%)and 104(16.9%),respectively.(3)The differences of BMI,degree of education,the type of atrial fibrillation,the score of CHA2DS2-VASC and whether accepted antithrombotic therapy in readmission were statistically significant(P <0.05).the results of Logistic regression analysis showed that BMI(OR=0.648,95% CI,0.479-0.877,P=0.005),the type of atrial fibrillation(OR=1.991,95% CI,1.429-2.773,P<0.001),whether accepted antithrombotic therapy(OR=0.601,95% CI,0.373-0.969,P=0.037)and the score of quality of life(OR=0.979,95% CI,0.961-0.997,P=0.026)entered the Regression equation.(4)Single factor analysis found that self-management ability was associated with quality of life in patients of atrial fibrillation(95%CI,-0.351--0.18,P<0.001).(5)The direct factors of readmission in patients with atrial fibrillition were the score of quality of life,the types of atrial fibrillation and BMI and the total value were-0.074,0.200 and-0.076 separately.The indirect factors included whether accepted antithrombotic therapy and the total score of selfmanagement ability and the indirect value were 0.010 and 0.010.The structural equation modeling indicated that every indicator of goodness-of-fit index were CMIN/DF=1.215,NFI=0.971,TLI=0.957,CFI=0.994,IFI=0.995,RMSEA=0.019.Conclusion: The total score and the scores of three dimension were low.The score of self-management ability in patients taken warfarin was highest and that of in patients hich did not accept antithrombotic therapy was lowest.The direct factors of readmission in patients with atrial fibrillition were the score of quality of life,the type of atrial fibrillation and BMI.Self-management ability could influent the quality of life in patients with atrial fibrillation and then affected the readmission.