Motivational interviewing to improve the self-care behaviors for patients with chronic heart failure: A randomized controlled trial

Objectives:This study aimed to investigate the effect of motivational interviewing on the self-care behaviours in patients with chronic heart failure.Methods:Sixty-two hospitalized patients with chronic heart failure were recruited in this study from April 2014 to April 2015 from a hospital.Twenty-nine patients were in the intervention group,and 33 patients were in the control group.Patients in the intervention group received four sessions of motivational interviewing,whereas those in the control group received traditional health education.At 2,4,and 8 weeks post-discharge,the intervention group underwent telephone follow-up based on motivational interviewing,whereas the control group underwent routine telephone follow-up.Primary outcome was measured using the Self-care of Heart Failure Index at baseline and at 2 months postdischarge.Results:Before intervention,the self-care behaviours scores were 79.00±48.80 in the intervention group and 88.68±29.26in the control group.No statistically significant differences were found between two groups in scores for each subscale and total scale(P>0.05).After intervention,the scores of self-care behaviours in the two groups were both improved at 155.13±35.65 for the intervention group and 115.44±22.82 for the control group with statistically significance(P<0.01).The score of self-care behaviours increased by 76.13 point in the intervention group on average,whereas 26.76 point in the control group.There was significant difference between increases in scores of self-care behaviours in two groups(P<0.01).Conclusions:The self-care behaviours of patients with chronic heart failure could be improved effectively through motivational interviewing.

提高急性心肌梗死康复期患者自我护理能力作用的探讨

目的:探讨急性心肌梗死康复期患者自我护理能力与康复效果、生活质量的关系。方法:81例急性心肌梗死患者在出院时给予提高自我护理能力的健康教育。采用欧洲心力衰竭患者自我护理行为量表(EHFScBS)和明尼苏达心力衰竭生活质量调查表进行自我护理能力和生活质量的评价,并记录患者心力衰竭发生和心肌梗死再入院的例数。随访6个月。结果:患者EHFScBS评分为(41.6±11.8)分;自我护理能力受文化程度影响。文化程度较高者,自我护理能力相对越高(F=5.446,P=0.008)。同时自我护理能力较强的患者生活质量也相对较高(F=6.354,P=0.000)。EHFScBS评分和明尼苏达心力衰竭生活质量评分呈正相关(r=0.711,t=3.224,P=0.012);在EHFScBS评分中低分者越易造成心力衰竭的发生(χ2=8.188,P=0.042),也更倾向于再次入院(χ2=8.188,P=0.042)。结论:急性心肌梗死康复期患者的自我护理能力和生活质量及心力衰竭发生及再入院率有密切的关系,应努力提高其自我护理能力。

欧洲五维健康量表应用于慢性心力衰竭患者的科学性考评

目的:对欧洲五维健康量表(EQ-5D)用于慢性心力衰竭(以下简称心衰)患者进行测评。方法:采用EQ-5D对符合纳入标准的120例心衰患者[射血分数正常心衰(HFNEF)、射血分数减少心衰(HFREF)患者各60例]和60例非心衰(NHF)患者进行调查,同时采用明尼苏达心力衰竭生活质量量表(MLHFQ)对患者进行调查,作为对照。记录调查完成情况,采用克朗巴赫α系数考核量表的信度;采用因子分析考核量表的建构效度,采用Pearson相关分析考察患者EQ-5D和MLHFQ的关系,评测量表的标准效度;采用非参数检验考察心衰患者与非心衰患者是否存在差别,评测量表的反应度。结果:可行性分析:量表的回收率为100%,完成率为100%。信度分析:量表健康描述系统克朗巴赫α系数为0.761。效度分析:量表的总分、时间权衡转换模型(TTO)转换值、可视化评分(VAS)与MLHFQ总分的相关系数分别为0.687、-0.636、-0.278(P<0.01)。反应度分析:采用TTO转换值进行组间比较,HFNEF组、HFREF组TTO转换值分别与NHF组比较,差异均有统计学意义(P<0.01)。结论:EQ-5D可用于心衰患者的生活质量评价,具有较好的信度、效度和反应度。

基于COSMIN操作指南的心力衰竭患者自我护理指数的系统评价

目的评价心力衰竭患者自我护理指数的测量学属性及相应研究的方法学质量,为临床的选择与使用提供循证依据。方法检索Embase、Web of Science、CINAHL、PubMed、中国知网、万方数据库建库至2022年3月27日发表的相关研究,基于COSMIN操作指南对量表的测量属性及研究的方法学质量进行评价,最后综合评价结果形成对于量表的最终推荐意见。结果共纳入14项研究。SCHFI v.7.2为A级推荐,存在高级别证据支持具有"充分"的内部一致性、结构效度的假设检验,中级别证据支持其具有"充分"的内容效度、结构效度、重测信度。SCHFI v.6.2为B级推荐,存在高级别证据支持其具有"充分"的结构效度的假设检验,中级别证据支持其具有"充足"的内容效度,但结构效度及内部一致性、重测信度研究结果不一致。结论从现有证据看,SCHFI v.7.2为心力衰竭患者自我护理的理想测评工具,但目前相关研究数量不足,缺少对于测量误差、校标效度、反应度的检验,未来有待更多高质量证据加以支撑。