郑州市老年慢性心力衰竭患者及其照护者健康素养对患者自我护理的影响

Effects of patient and caregiver health literacy on self-care in elderly chronic heart failure patients in Zhengzhou city

目的了解老年慢性心力衰竭(CHF)患者及其照护者健康素养水平现况,并探讨双方健康素养水平对患者自我护理的影响。方法采用便利抽样法,选取2019年7月至11月在郑州市3所综合性三级甲等医院住院的500例老年CHF患者及500名照护者为调查对象。采用患者及照护者一般资料调查表、中文版心力衰竭特异性健康素养量表、2009年中国公民健康素养调查问卷及中文版心力衰竭患者自我护理量表进行调查。采用SPSS 22.0统计软件进行数据分析。根据数据类型,分别采用t检验或χ^(2)检验进行组间比较。采用Pearson相关分析患者与照护者双方的健康素养与患者自护能力的相关性。采用多重线性回归分析双方的健康素养对患者自护能力的影响。结果Pearson相关分析结果显示,老年CHF患者及其照护者的健康素养与患者自我护理均呈显著正相关(r=0.757、0.655,均P<0.01)。多元回归分析显示,患者的健康素养(β=0.405,P<0.05)、照护者的健康素养(β=0.292,P<0.01)均是影响患者自我护理能力的主要因素。结论老年CHF患者及其照护者高水平健康素养均可有效促进患者的自护能力。临床医护人员需关注评估二者健康素养水平,将老年CHF照护者也包含到心力衰竭治疗照护团队中,初步构建出针对照护者的健康宣教架构,进一步研究适合双方的健康素养干预方案,以期提高患者的自我护理能力,改善心力衰竭结局。

Objective To investigate the current status of health literacy of elderly patients with chronic heart failure(CHF)and their caregivers,and to explore the effects of their literacy levels on patient′s self-care.Methods Convenience sampling was used to select 500 caregivers and 500 elderly CHF inpatients who were hospitalized in 3 tertiary general hospitals in Zhengzhou City.Surveys were conducted using the general information questionnaire for the patients and their caregivers,Chinese version of the HF specific health literacy scale,2009 Chinese citizen health literacy questionnaire,the Chinese version of the heart failure self-care behavior scale.SPSS statistics 22.0 was used for data analysis.For different data types,student′s t test or Chi-square test were employed for intergroup comparison.Pearson correlation analysis was adopted to analyze the correlation between health literacy and self-care ability of patients and caregivers.Multiple linear regression analysis was performed to determine the effect of health literacy on self-care ability of patients.Results Pearson correlation analysis showed that the levels of patient and caregiver health literacy were positively correlated with the patient′s self-care behaviors(r=0.757,0.655,both P<0.01).Multiple linear regression analysis indicated that the health literacy levels of elderly CHF patients(β=0.405,P<0.05)and their caregivers(β=0.292,P<0.01)were main influencing factors for patient′s self-care.Conclusion Improving the health literacy levels of elderly CHF patients and caregivers can promote the self-care behaviors of patients.We should pay attention to and assess their health literacy levels.The caregivers should be included in the heart failure treatment and care team in order to initially establish a health education framework for the caregivers.And the health literacy intervention program suitable for both sides should be further studied so as to improve the self-care ability of patients and improve the outcome of heart failure.