提升心力衰竭患者自我管理的策略

Strategies to Improve Self-management in Heart Failure Patients

目的回顾关于心力衰竭自我管理的研究,并研究对改善患者自我管理具有能重要作用的教育、行为和社会心理策略。方法基于系统评价和荟萃分析指南的首选报告项目进行系统综述。通过使用Pub Med和Up To Date广泛搜索从1999年到2017年的文献。结果影响心力衰竭患者的自我管理包括内源性因素和外源性因素两方面。其中,内源性因素包括患者的认知能力、健康素养、和行为改变;外源性因素包括知识和技能、治疗相关因素和医护团队因素。结论提高患者自我管理可以提高患者的依从性,提升患者生活质量,改善临床结果,减少再次入院次数并降低住院费用。

Objective To review the available studies on heart failure self-management,and investigate educational,behavioral and psychosocial strategies which plays an important role to improve patient self-management.Methods A literature review was conducted based upon the preferred reporting items for systematic reviews and meta-analyses(PRISMA)guidance.The articles identified through an extensive search using PubMed and UpToDate from 1999 to 2017.Results The self-management of patients with heart failure included endogenous factors and exogenous factors.Among them,endogenous factors include cognitive ability,health literacy,and behavioral changes,while exogenous factors include knowledge and skills,treatment related factors and medical team factors.Conclusion Improved self-management will increase compliance,promote patient quality-of-life,advance clinical outcomes,reduce hospital re-admission and will decrease hospitalization costs.