Mei Yang, Xiuting Zhang, Wenjie Fang, Yilin Zhang, Xiuzhen Fan
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引用次数: 0
Abstract
Aim: This study aimed to identify the heterogeneous trajectories of frailty and determine the predictors of distinct trajectories in patients with heart failure.
Design: A longitudinal study.
Methods: A total of 253 patients with heart failure were recruited at the cardiology department of a tertiary hospital between February and December 2023. Frailty was assessed at baseline, 1 and 4 months after discharge. Patients' sociodemographic characteristics, physical symptoms, nutritional status, psychological distress, illness perception and social networks were obtained at baseline using a structured questionnaire. Group-based trajectory modelling was performed to identify the heterogeneity of the trajectories of frailty. Multiple logistic regression and decision tree models were used to explore the predictors of heterogeneous trajectories of frailty.
Results: Three distinct trajectories of frailty were identified in patients with heart failure: low frailty with high-degree improvement group (46.2%), moderate frailty with high-degree improvement group (41.1%) and high frailty with low-degree improvement group (12.6%). Multiple logistic regression analysis showed that physical symptoms, nutritional status, illness perception and employment status were entered as independent predictors of heterogeneous trajectories of frailty. The decision tree model demonstrated that physical symptoms were the primary predictors, followed by nutritional status, illness perception and psychological distress.
Conclusions: Three distinct categories of frailty trajectories were identified in patients with heart failure. Physical symptoms, nutritional status, psychological distress, illness perception and employment status were independent predictors of heterogeneous trajectories of frailty, with physical symptoms being the most important predictor.
Implication to clinical practice: Dynamic frailty assessment is recommended. Interventions aimed at alleviating physical symptoms, psychological distress and negative illness perception, and improving nutritional status may be conducive to delaying or reversing frailty in patients with heart failure, particularly in unemployed individuals.
Reporting method: The reporting followed the STROBE guideline.
Patient or public contributions: No patient or public contribution.
期刊介绍：
The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice.
JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice.
We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.
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