Subramanian Usha, Hopp Faith, Mitchinson Allison, Lowery Julie
Roudebush VA Medical Center, Indianapolis, IN 46202, USA.
Congest Heart Fail. 2008 Jan-Feb;14(1):6-11. doi: 10.1111/j.1751-7133.2008.07174.x.
To address the need for more information on predictors of adherence to heart failure (HF) self-management regimens, this study analyzed surveys completed by 259 HF patients receiving care at 2 Veterans Affairs hospitals in 2003. Linear multivariable regression models were used to examine general health status, HF-specific health status (Kansas City Cardiomyopathy Questionnaire) self-management education, and self-efficacy as predictors of self-reported adherence to salt intake and exercise regimens. Self-management education was provided most often for salt restriction (87%) followed by exercise (78%). In multivariable regression analyses, education about salt restriction (P=.01), weight reduction (P=.0004), self-efficacy (P=.03), and health status (P=.003) were significantly associated with patient-reported adherence to salt restriction. In a similar model, self-efficacy (P=.006) and health status (P< or = .0001), but not exercise education, were significantly associated with patient-reported exercise adherence. Findings suggest that provider interventions may lead to improved adherence with HF self-management and thus improvements in patients' health.
为满足获取更多关于心力衰竭（HF）自我管理方案依从性预测因素信息的需求，本研究分析了2003年在两家退伍军人事务医院接受治疗的259例HF患者所完成的调查问卷。采用线性多变量回归模型来检验一般健康状况、HF特异性健康状况（堪萨斯城心肌病问卷）、自我管理教育以及自我效能，将其作为自我报告的盐摄入和运动方案依从性的预测因素。自我管理教育最常针对的是限盐（87%），其次是运动（78%）。在多变量回归分析中，限盐教育（P = 0.01）、体重减轻（P = 0.0004）、自我效能（P = 0.03）和健康状况（P = 0.003）与患者报告的限盐依从性显著相关。在类似模型中，自我效能（P = 0.006）和健康状况（P≤0.0001），而非运动教育，与患者报告的运动依从性显著相关。研究结果表明，医疗服务提供者的干预措施可能会提高HF自我管理的依从性，从而改善患者的健康状况。
