摘要
Purpose:The guidelines on the management of patients with heart failure support intensive patient education on self-care.The present study aimed to evaluate the short-term and long-term impacts of a structured education provided by a qualified heart failure nurse on patients'self-care behavior and disease knowledge.Methods:One hundred fifty patients(66±12 years)hospitalized for heart failure participated in a structured one-hour educational session by a heart failure nurse.Patients completed a questionnaire comprising 15 questions(nine questions from the European Heart Failure Self-Care Behavior Scale[EHFScB-9]and six on the patients'disease knowledge)one day before and one day and six months after the educational session.Possible responses for each question ranged from 1(complete agreement)to 5(complete disagreement).Results:After the educational session,the total EHFScB-9 score improved from 24.31±6.98 to 14.94±6.22,and the disease knowledge score improved from 18.03±5.44 to 10.74±4.30(both P<0.001).Scores for individual questions ranged from 1.26±0.81(adherence to the medication protocol)to 3.66±1.58(everyday weighing habits)before the education.The greatest improvement after education was observed on response to weight gain(-2.00±1.57),daily weight control(—1.77±1.64),and knowledge on the cause of patients'heart failure(-1.53±1.43).At 6-month follow-up,EHFScB-9 score was 17.33±7.23 and knowledge score was 12.34±5.30(both P<0.001 compared with baseline).No factor was predictive of an insufficient teaching effect.Conclusions:The educational program led by a qualified nurse improves patients'self-care behavior and disease knowledge with a persistent effect at 6-month follow-up.There are no patient characteristics which preclude the implementation of an educational session.
目的有关心力衰竭患者管理的指南支持对患者进行自我保健的强化教育。本研究旨在评估由认证的心力衰竭护士提供的结构化教育对患者疾病知识和自我护理行为的长期影响。方法150例因心力衰竭住院的患者参加T由心力衰竭护士进行的1h结构化教育课程,患者年龄(66±12)岁。患者在课程教育前1天、1天后和6个月后完成包含15个问题的问卷。问卷中包括欧洲心力衰竭自我护理行为量表(the European Heart Failure Self-Care Behaviour Scale,EHFScB)中的9个问题(EHFScB-9)及关于疾病知识的6个问题。每个问题计分范围从1(完全同意)至5(完全不同意),得分越高表示知识或行为越差。结果完成教育活动1天后,患者的疾病知识评分从(18.03±5.44)分降低至(10.74±4.30)分,EHFScB-9总评分从(24.31±6.98)分降低至(14.94±6.22)分(均P<0.001)。教育前患者单个问题评分最低的条目“遵守药物治疗方案”为(1.26±0.81)分,最高的条目“日常监测体重的习惯”为(3.66±1.58)分。教育后,患者对心力衰竭原因的了解程度、对体重增加的反应和日常体重监测习惯改善最为明显。6个月后随访时,疾病知识得分为(12.34±5.30)分,EHFScB-9得分(l7.3±7.2)分,仍低于基线水平(P<0.001)。未发现任何影响教育效果的患者因素。结论由认证的心力衰竭护士进行的健康教育项目可改善患者的疾病知识和自我保健行为,并在6个月的随访中持续有效。患者个人特征不影响健康教育的效果。
基金
supported by a grant of the German Foundation for the Chronically Ill,Alexander strasse 26,90762 Furth,Germany.
