“High anxiety-high autonomy” profile of psychological needs for cardiac rehabilitation in patients after cardiac valve replacement: a cross-sectional study

Xiang Xiaorun; Zhang Sha; Deng Yao; Wang Ya; Ye Maoting; Sun Wei

doi:10.16016/j.2097-0927.202602084

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“High anxiety-high autonomy” profile of psychological needs for cardiac rehabilitation in patients after cardiac valve replacement: a cross-sectional study

Evidence-Based Nursing Horizons | 更新时间：2026-10-19

- “High anxiety-high autonomy” profile of psychological needs for cardiac rehabilitation in patients after cardiac valve replacement: a cross-sectional study
- Journal of Army Medical University Vol. 48, Issue 19, Pages: 2800-2808(2026)
- 作者机构：
  
  1.陆军军医大学（第三军医大学）第一附属医院，心脏外科，重庆
  2.陆军军医大学（第三军医大学）第一附属医院，胸外科，重庆
  3.陆军军医大学（第三军医大学）第一附属医院，中医与风湿免疫科，重庆
  5.陆军军医大学（第三军医大学）第一附属医院，临床护理学教研室，重庆
  4.陆军军医大学（第三军医大学）护理系，重庆
- 作者简介：
  
  Sun Wei，E-mail： sunfamily@tmmu.edu.cn
- 基金信息：
  
  the General Project of Natural Science Foundation of Chongqing(CSTB2022NSCQ-MSX1400)
- DOI：10.16016/j.2097-0927.202602084
  CLC： R195.4;R493;R654.2
- Received：24 February 2026，
  
  Revised：2026-06-04，
  
  Accepted：08 June 2026，
  
  Published：15 October 2026
- 稿件说明：
移动端阅览
向小润，张沙，邓瑶，等.心脏瓣膜置换术后患者心脏康复心理需求呈“高焦虑-高自主性”特征：一项横断面研究［J］.陆军军医大学学报，2026，48（19）：2800-2808.DOI：10.16016/j.2097-0927.202602084.

Xiang X R，Zhang S，Deng Y，et al.“High anxiety-high autonomy” profile of psychological needs for cardiac rehabilitation in patients after cardiac valve replacement： a cross-sectional study［J］.J Army Med Univ，2026，48（19）：2800-2808.DOI：10.16016/j.2097-0927.202602084.
向小润，张沙，邓瑶，等.心脏瓣膜置换术后患者心脏康复心理需求呈“高焦虑-高自主性”特征：一项横断面研究［J］.陆军军医大学学报，2026，48（19）：2800-2808.DOI：10.16016/j.2097-0927.202602084. DOI：

Xiang X R，Zhang S，Deng Y，et al.“High anxiety-high autonomy” profile of psychological needs for cardiac rehabilitation in patients after cardiac valve replacement： a cross-sectional study［J］.J Army Med Univ，2026，48（19）：2800-2808.DOI：10.16016/j.2097-0927.202602084. DOI：

摘要

目的

随着人口老龄化进程加快，心脏瓣膜病患病率持续上升，心脏瓣膜置换术（cardiac valve replacement，CVR）是其主要治疗方式之一。然而，患者术后症状重、功能恢复慢，需长期心脏康复。我国心血管疾病患者心脏康复（cardiac rehabilitation，CR）参与率低于30%，本研究旨在明确CVR术后患者对CR的心理需求特征并分析相关影响因素，从而为制定个体化、精准康复指导方案提供理论依据。

方法

采用横断面研究设计方案，采用便利抽样法于2024年9月至2025年10月选取陆军军医大学第一附属医院心脏外科接受CVR的患者305例，使用一般资料调查表收集患者病史资料，心脏康复量表（cardiac rehabilitation inventory，CRI）调查患者个性化CR心理需求，患者迁移应激量表（Relocation Stress Syndrome Scale-Short Form，RSSs-SF）调查患者迁移应激水平，慢病患者自我效能量表（Self-Efficacy to Manage Chronic Disease Scale，SEMCD）调查患者疾病自我管理能力。以单因素分析和相关性分析中差异具有统计学意义的指标作为自变量，以CR各维度得分作为因变量，使用多元线性回归分析CR各维度得分的影响因素。

结果

305例CVR术后患者CR心理需求的自主性维度得分为20（15，22）分，过程焦虑维度得分为27（26，28）分，结果焦虑维度得分为16（16，17）分；73.8%的患者康复自主性较高，87.9%的患者存在较高过程焦虑，100%的患者存在较高结果焦虑。单因素分析结果显示，CVR术后患者的CR心理需求自主性得分，在不同症状管理自我效能、护理认知患者中存在统计学差异；CR心理需求过程焦虑得分，在不同主要照顾者年龄、婚姻状况及情感状态患者中存在统计学差异；CR心理需求结果焦虑得分，在不同主要照顾者年龄、疼痛程度患者中存在统计学差异（

0.05）。多因素线性回归分析结果显示：瓣膜反流程度（

=-0.118，

=0.048）、病人对护理的认知（

=-0.244，

0.001）是自主性的独立影响因素；情感因素（

=0.176，

=0.003）、主要照顾者年龄（

=-0.122，

=0.046）是过程焦虑的独立影响因素；主要照顾者年龄（

=-0.136，

=0.028）是结果焦虑的独立影响因素。

结论

CVR术后患者CR心理需求呈“高焦虑-高自主性”特征。其中，自主性受瓣膜反流程度和患者对护理的认知影响，过程焦虑受情感因素和主要照顾者年龄影响，结果焦虑受主要照顾者年龄影响。

Abstract

Objective

With the acceleration of population aging

the prevalence of heart valve disease continues to rise

and cardiac valve replacement (CVR) is one of the main treatment modalities. However

these patients experience severe postoperative symptoms and slow functional recovery

requiring long-term cardiac rehabilitation (CR). The participation rate of CR among patients with cardiovascular diseases in China is lower than 30%. This study aims to clarify the characteristics of psychological needs for CR in patients after CVR and analyze the related influencing factors

so as to provide a theoretical basis for developing guidance programs of individualized and precision rehabilitation.

Methods

A cross-sectional study was conducted on 305 patients who underwent CVR and enrolled through convenience sampling in Department of Cardiac Surgery of First Affiliated Hospital of Army Medical University from September 2024 to October 2025. A general information questionnaire was used to collect medical history

and Cardiac Rehabilitation Inventory (CRI)

Relocation Stress Syndrome Scale-Short Form (RSSs-SF) and Self-Efficacy to Manage Chronic Disease Scale (SEMCD) were applied to investigate the individualized CR psychological needs

relocation stress levels

and disease self-management ability of the patients. Indicators with statistically significant differences in univariate analysis and correlation analysis were taken as independent variables

and the scores of each dimension of CR were taken as dependent variables. Multiple linear regression analysis was utilized to analyze the influencing factors of the scores of each dimension of CR.

Results

Among the 305 patients after CVR

the scores of cardiac rehabilitation needs were 20 (15

22) for autonomy dimension

27 (26

28) for process anxiety dimension

and 16 (16

17) for outcome anxiety dimension. There were 73.8% patients with high rehabilitation autonomy

87.9% with higher process anxiety

and 100% w

ith higher outcome anxiety. Univariate analysis demonstrated statistically significant differences in autonomy score of CR psychological needs among patients with varying symptom management self-efficacy and nursing cognition levels. Process anxiety differed significantly among patients with different primary caregiver age

marital status

and emotional status

whereas outcome anxiety varied significantly among those with different caregiver age and pain severity (

0.05). Multiple linear regression analysis revealed that severity of valve regurgitation (

=-0.118

=0.048) and cognition of nursing care (

=-0.244

0.001) were independent influencing factors of autonomy; emotional status (

=0.176

=0.003) and primary caregiver age (

=-0.122

=0.046) were independent influencing factors of process anxiety; and age of primary caregiver (β=-0.136

=0.028) was an independent influencing factor of outcome anxiety.

Conclusion

The psychological needs for CR in patients after CVR are characterized by “high anxiety-high autonomy”. Specifically

autonomy is influenced by the degree of valve regurgitation and patients’ cognition of nursing care

process anxiety is influenced by emotional factors and age of primary caregiver

and outcome anxiety is influenced by age of primary caregiver.

关键词

Keywords

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