Study on influencing factors of social isolation in patients with chronic heart failure based on social ecosystem theory

ObjectiveTo explore the influencing factors of social isolation in patients with chronic heart failure(CHF) based on social ecosystem theory, to provide reference for clinical nursing intervention.

MethodsOne hundred patients with CHF were surveyed with Lubben social network scale-6, simplified loneliness scale, heart failure symptom status questionnaire, community self-efficacy scale, disease acceptance scale, family care index questionnaire and self-made general questionnaire to analyze the influencing factors of social isolation in patients with CHF at micro, meso and macro levels.

ResultsThere were significant differences in the scores of objective social isolation and subjective social isolation between CHF patients with different age, marriage, residence status, education level, self-perceived economic level and using smart phones or not(P<0.01).The influence of recreational facilities around the community on the objective social isolation score of CHF patients was statistically significant(P<0.05), while the influence on the subjective social isolation score was not statistically significant(P>0.05).Correlation analysis showed that the total score of heart failure symptom was negatively correlated with disease acceptance, total score of family care and objective social isolation(P<0.05 to P<0.01), and positively correlated with subjective social isolation(P<0.05);the total score of community self-efficacy was significantly positively correlated with disease acceptance, total score of family care and objective social isolation(P<0.01), and significantly negatively correlated with subjective social isolation(P<0.01);the disease acceptance was significantly positively correlated with the total score of family care and objective social isolation(P<0.01), and negatively correlated with subjective social isolation(P<0.01);the total score of family care was significantly negatively correlated with subjective social isolation(P<0.01);and the objective social isolation was negatively correlated with subjective social isolation(P<0.05).Multiple regression analysis showed that living alone or not, education level and heart failure symptom were the influencing factors of objective social isolation(P<0.05 to P<0.01), and living alone or not, community self-efficacy, disease acceptance and family care were the influencing factors of subjective social isolation(P<0.05 to P<0.01).

ConclusionsTargeted intervention measures can be formulated according to the types of social isolation and the characteristics of influencing factors of patients with CHF in clinical nursing work.Subjective social isolation is mostly caused by psychological factors.It should be combined with family intervention to actively improve patients' community self-efficacy and popularize disease knowledge.