我国心力衰竭患者疾病认知程度的现况调查

Current Status on Knowledge of Heart Failure Among Heart Failure Patients in China

目的:了解我国心力衰竭患者的疾病认知程度,并评估与其相关的人口学及临床因素,为实施相应的临床干预提供依据。方法:对我国2012~2014年不同地区、不同级别医院(24家)的970例心力衰竭患者进行问卷调查,内容包括心力衰竭知晓、生活方式、药物依从性、就医便利性、经济负担、健康宣教。生活方式改善包括低盐饮食、适量运动和监测体重。采用Pearson卡方分析探究可能影响心力衰竭认知程度的人口学及临床因素。结果:我国心力衰竭患者中心力衰竭知晓率、药物依从率及健康教育接受率分别为74.8%、83.0%和40.8%。全面改善生活方式的患者仅占5.6%。不同的医院级别、患者受教育程度、NYHA心功能分级、婚姻状况影响患者的心力衰竭知晓率(P均<0.01)。农村患者的疾病知晓率、药物依从率及健康教育接受率明显低于城镇患者(P均<0.01)。二、三级医院患者的药物依从率和健康教育接受率显著高于一级医院(P均<0.01)。结论:我国心力衰竭患者总体疾病认知程度较差,表现为知晓率、药物依从率、健康教育接受率低下,自我保健意识匮乏。各级医护人员应履行疾病告知义务,加强健康宣教力度,以期改善药物依从性,督促生活方式改良。

Objectives: To evaluate the illness knowledge in patients with heart failure(HF),and to observe the demographic and clinical factors related to the knowledge of HF in this patient cohort in order to provide the basis for carrying out appropriate clinical interventions.Methods: From 2012 to 2014, a total of 970 patients with HF in various hospitals from different regions in China were investigated using the knowledge scale questionnaire, which included awareness, lifestyle, drug adherence, convenience to medical care, economic burden and health education of heart failure. Lifestyle improvement was defined as low-salt diet, moderate exercise and weight monitoring. Pearson’s chi-squared test was used to explore the contribution of sociodemographic and clinical variables to levels of HF knowledge. Results: The rates of awareness, drug adherence and disease education of HF in Chinese HF patients were 74.8%,83.0% and 40.8% respectively. The proportion of patients with comprehensive lifestyle improvement accounted for only 5.6%. Hospital level, education level, NYHA function assessment, marital status all affected the awareness rate of heart failure(P<0.01). Rural HF patients had lower rates of awareness, drug adherence and disease education than urban HF patients(P<0.01). The drug adherence rate and acceptance rate of health education of HF patients admitted to secondary and tertiary hospitals were significantly higher than those admitted to primary hospitals(P<0.01).Conclusions: In general, the level of HF knowledge among HF patients in China is unsatisfactory, which is characterized by low rates of illness awareness, drug adherence, disease education and lack of self-health care. Medical staff should fulfill the duty of disease information, strengthen health education by different strategies, and reach the goal of improving drug adherence and life style among HF patients in China.