González Beatriz, Lupón Josep, Parajón Teresa, Urrutia Agustín, Altimir Salvador, Coll Ramon, Prats Montserrat, Valle Vicente
Unitat d'Insuficiència Cardíaca, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, 08916 Badalona, Spain.
Eur J Cardiovasc Nurs. 2004 Apr;3(1):61-9. doi: 10.1016/j.ejcnurse.2003.12.001.
To know how compliant patients are, how much they know about their disease and treatment, and how their level of self-care is.
We performed a short nurse questionnaire during the first visit to a new Heart Failure Unit.
Three hundred and twenty-four patients have been evaluated, with a mean age of 65.4 years. Ninety-eight patients (30%) knew and understood the performance of the heart and 85 (29%) understood the disease. Two-hundred and nineteen (67%) knew more than three signs of worsening symptoms. One-hundred and five (32%) knew all the names of the medication they were taking and 74 (23%) knew the action of these medications. Two-hundred and ninety-four (91%) said they were taking all the medication prescribed and 229 (71%) carried on always their written prescription. Sixty-two percent of patients controlled weight only at the medical visit and only 14% controlled weight more than once a week. Fifty-nine (18%) controlled blood pressure more than once a week, while 45% controlled it only at the medical visit. Only 33% of patients were said always to follow sodium restricted diet. The great majority (93%) never smoked and only very rarely took alcohol (83%). While only 18 (6%) performed some kind of physical exercise, the majority (83%) did walking and daily living activities. The 85% of patients with ischemic heart disease knew how to use sublingual nitro-glycerine. When subgroups were analysed, we found significant differences by age, gender and previous specialist management. Younger patients, men and patients referred from the Cardiology outpatient clinic showed a higher level of knowledge and understanding of several aspects of disease and treatment, and performed more physical activities, compared to older patients, women and patients referred from other departments. On the contrary, older patients showed better adherence with sodium restriction, and, as women, better smoking and drinking habits.
There is a lot of work to do in nurse-guided education of patients with heart failure, although treatment compliance, use of nitro-glycerine and abstinence of smoking and alcohol intake seem to be quite assumed by the majority of our patients. Significant differences in knowledge and behaviour were evident between younger and older patients, between men and women, and relating to previous specialist management. In spite of that, we found no differences in treatment compliance.
了解患者的依从性如何,他们对自身疾病及治疗的了解程度如何,以及他们的自我护理水平如何。
在患者首次就诊新的心力衰竭科时,我们对护士进行了简短问卷调查。
共评估了324例患者,平均年龄65.4岁。98例患者(30%)了解并理解心脏的功能,85例(29%)了解疾病。219例(67%)知道三种以上症状恶化的体征。105例(32%)知道所服用药物的所有名称,74例(23%)知道这些药物的作用。294例(91%)表示他们按医嘱服用了所有药物,229例(71%)始终遵循书面处方。62%的患者仅在就诊时控制体重,只有14%的患者每周控制体重超过一次。59例(18%)每周测量血压超过一次,而45%的患者仅在就诊时测量血压。只有33%的患者表示始终遵循限钠饮食。绝大多数患者(93%)从不吸烟,很少饮酒(83%)。虽然只有18例(6%)进行某种体育锻炼,但大多数患者(83%)进行散步和日常生活活动。85%的缺血性心脏病患者知道如何使用舌下硝酸甘油。当对亚组进行分析时,我们发现年龄、性别和先前的专科治疗存在显著差异。与老年患者、女性患者以及从其他科室转诊的患者相比,年轻患者、男性患者以及从心脏病门诊转诊的患者对疾病和治疗的几个方面表现出更高的知识水平和理解程度,并且进行更多的体育活动。相反,老年患者在限钠方面依从性更好,女性患者在吸烟和饮酒习惯方面更好。
在护士指导下对心力衰竭患者进行教育仍有大量工作要做,尽管大多数患者在治疗依从性、硝酸甘油使用以及戒烟戒酒方面做得较好。年轻患者与老年患者、男性与女性以及与先前的专科治疗相关的知识和行为存在显著差异。尽管如此,我们发现治疗依从性并无差异。