心衰知识对慢性心力衰竭患者自我护理及照顾者自我护理贡献的交互影响

目的:探讨心衰知识对慢性心力衰竭(CHF)患者自我护理及照顾者自我护理贡献的交互影响。方法:选取2021年7月1日~2022年7月31日心内科住院的199例(名)CHF患者、照顾者作为调查对象;采用自制一般资料调查表、心衰知识测试(HFKT)问卷、中文版心衰自我护理指数量表(SCHFI)和中文版照顾者对心衰自我护理作用指数量表(CC-SCHFI)调查CHF患者、照顾者,并建立心衰知识对自我护理的主客体互倚模型(APIM)。结果:患者的心衰知识水平低于照顾者(P<0.01),患者心衰知识水平与照顾者自我护理贡献呈正相关(P<0.01),照顾者心衰知识水平与患者自我护理呈正相关(P<0.01);APIM分析结果显示,CHF患者、照顾者的心衰知识均可正向预测自身及对方的自我护理。结论:CHF患者的自我护理、照顾者的自我护理贡献受双方心衰知识水平的影响,为帮助患者、照顾者更好地应对疾病,建议临床医护人员重视提高患者、照顾者的心衰知识水平,并将两者视为共同体,探索以心衰知识为焦点的干预方案。

老年慢性心力衰竭患者心衰知识水平及相关因素的调查与分析

调查老年慢性心力衰竭患者的心衰知识水平,并分析其相关影响因素。方法 描述性研究设计,方便取样,采用心衰知识问卷和自制问卷调查172名老年慢性心力衰竭患者的一般情况资料和心衰知识水平。结果:老年慢性心力衰竭患者心衰知识水平为(6.44±2.84)分;文化程度、是否接受过心衰知识教育、因心衰住院次数、年龄及家庭照顾情况是影响老年慢性心力衰竭患者心衰知识水平的主要因素(P<0.05);结论:老年慢性心力衰竭患者心衰知识水平较低,文化程度、是否接受过心衰知识教育、因心衰住院次数、年龄与家庭照顾情况是影响老年慢性心力衰竭患者心衰知识水平的主要相关因素。

心力衰竭患者医护联合门诊自我管理指导模式的构建与应用

目的构建心力衰竭患者医护联合门诊自我管理指导模式,探讨其对心力衰竭患者自我护理行为的影响。方法将263例心力衰竭医护联合门诊就诊的患者按照就诊时间分为对照组131例,干预组132例。对照组进行常规诊疗和健康教育,干预组在对照组的基础上采用心力衰竭患者医护联合门诊自我管理指导模式,主要采取门诊健康教育、线上健康教育讲座、榜样案例宣传的方式进行自我管理健康指导。干预前、干预3个月后,采用心力衰竭自我护理指数量表、心力衰竭知识问卷、堪萨斯城心肌病患者生活质量量表对两组患者进行评价。结果干预3个月后,干预组自我护理行为、心力衰竭知识水平及生活质量显著优于对照组(均P<0.01)。结论心力衰竭患者医护联合门诊自我管理指导模式可提高患者的自我护理行为、心力衰竭知识水平及生活质量,更好地为患者提供高质量的延续性护理。

多媒体技术在心力衰竭患者健康教育中的效果评价

目的评价多媒体健康教育模式在心衰患者健康教育实践中的应用效果。方法将南京市某三甲医院心脏内科住院的心力衰竭患者,按照随机数字表法分为两组,实验组实施多媒体技术联合书面资料的健康教育模式,对照组采用口头宣教和书面资料结合的健康教育模式,评估两组患者的心衰相关知识水平、住院满意度及自我护理行为能力。结果实验组患者在出院时、出院后1月、3月的心衰相关知识水平和自我护理能力高于对照组,有统计学差异(<0.05)。结论在心力衰竭患者健康教育中运用多媒体技术,可显著提高临床健康教育效果。

Gender differences in self-care maintenance and its associations among patients with chronic heart failure

Objectives:To identify the gender differences in self-care maintenance and its associations among chronic heart failure patients using the Information-Motivation-Behavioral Skills model.Methods:Two hundred and ten patients(54.0%female)with chronic heart failure participated in this cross-sectional study.Self-care,knowledge of heart failure,social support and illness perception were measured using the Self-Care of Heart Failure Index,the questionnaire of heart failure knowledge,the Perceived Social Support Scale,and the Revised Illness Perception Questionnaire,respectively.Results:Mean scores for self-care maintenance were 51.4±14.8 in men and 55.6±14.1 in women(t=-2.066,P<0.05).Associated factors of self-care maintenance were social support and self-care confidence in men and the knowledge of heart failure,self-care management and self-care confidence in women.The relationship between social support and self-care maintenance was meditated by selfcare confidence in men,whereas the relationship between knowledge of heart failure and self-care maintenance was meditated by self-care management and self-care confidence in women.Conclusions:Self-care maintenance were inadequate in both genders with chronic heart failure.Interventions for enhancing social support and self-care confidence in men patients,and strengthening knowledge of heart failure,self-care management and self-care confidence in women patients,may facilitate self-care maintenance.

Persistent effect of nurse-led education on self-care behavior and disease knowledge in heart failure patients

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.