Washburn Susan C, Hornberger Cynthia A, Klutman April, Skinner Lynn
School of Nursing, Washburn University, Topeka, KS 66621, USA.
J Cardiovasc Nurs. 2005 May-Jun;20(3):215-20. doi: 10.1097/00005082-200505000-00014.
Recurrent heart failure (HF) is the most common cause for readmission of elderly patients with HF. Patient education is an essential component of care for these patients. Healthcare providers must have a sufficient knowledge base to facilitate this education. This study aims to describe nurses' knowledge of HF self-management education principles. Fifty-one nurses working in a small Midwestern community hospital completed a 20-item true or false written survey developed by Albert et al (Heart Lung. 2002;31:102-112) to assess their knowledge of 5 areas of HF self-management. The sample included 14 nurses working in an intensive care unit and 41 nurses working on a general medical unit, all routinely providing care to patients with HF. The mean (+/-SD) HF self-care knowledge score was 14.6 +/- 2 (range = 9-19). There was no statistical difference in mean score between intensive care unit (14.7 +/- 1.6) and floor (14.5 +/- 2.1) nurses. Correct responses to individual survey items ranged from 20% to 100%; 6 questions resulted in mean scores >90% correct, 9 questions had mean scores between 70% and 90% correct, and 5 questions had mean scores <70% correct. Most respondents (90%) answered 6 questions correctly, but on 9 questions, 70% and 90% answered correctly. On 5 questions, less than 70% answered them correctly. Two questions (need for daily weight monitoring when asymptomatic and the importance of notifying the doctor of new onset or worsening of fatigue) were answered correctly by all participants. Subject areas of frequently missed questions were the use of nonsteroidal anti-inflammatory drugs, use of potassium-based salt substitutes, assessment of weight results, and physician notification of asymptomatic low blood pressure and momentary dizziness when rising. These results suggest that nurses working in a small community hospital may not be sufficiently knowledgeable in HF management principles. Additional emphasis on HF educational principles may improve the quality of patient education. One suggested intervention is to provide ongoing education for nurses regarding HF management.
复发性心力衰竭（HF）是老年心力衰竭患者再次入院的最常见原因。患者教育是这些患者护理的重要组成部分。医疗保健提供者必须具备足够的知识基础以促进这种教育。本研究旨在描述护士对心力衰竭自我管理教育原则的了解情况。在中西部一家小型社区医院工作的51名护士完成了由阿尔伯特等人编制的一份包含20道是非题的书面调查问卷（《心肺》。2002年；31：102 - 112），以评估她们对心力衰竭自我管理5个领域的了解。样本包括14名在重症监护病房工作的护士和41名在普通内科病房工作的护士，她们都常规为心力衰竭患者提供护理。心力衰竭自我护理知识的平均（±标准差）得分是14.6±2（范围 = 9 - 19）。重症监护病房护士（14.7±1.6）和普通病房护士（14.5±2.1）的平均得分没有统计学差异。对各个调查问卷项目的正确回答率从20%到100%不等；6个问题的平均得分正确率>90%，9个问题的平均得分正确率在70%到90%之间，5个问题的平均得分正确率<70%。大多数受访者（90%）正确回答了6个问题，但在9个问题上，70%到90%的人回答正确。在5个问题上，不到70%的人回答正确。所有参与者都正确回答了两个问题（无症状时每日体重监测的必要性以及将疲劳的新出现或加重情况告知医生的重要性）。经常答错问题的主题领域包括非甾体类抗炎药的使用、钾基盐替代品的使用、体重结果的评估以及无症状性低血压和起身时瞬间头晕的情况通知医生。这些结果表明，在小型社区医院工作的护士可能对心力衰竭管理原则了解不足。对心力衰竭教育原则给予更多重视可能会提高患者教育的质量。一种建议的干预措施是为护士提供关于心力衰竭管理的持续教育。
