Sayers Steven L, Riegel Barbara, Pawlowski Stephanie, Coyne James C, Samaha Frederick F
Philadelphia Veterans Affairs Medical Center, University of Pennsylvania, Philadelphia, PA, USA.
Ann Behav Med. 2008 Feb;35(1):70-9. doi: 10.1007/s12160-007-9003-x. Epub 2008 Feb 20.
Social support can influence treatment adherence of patients with chronic illnesses, which may explain the positive effects of social support on heart failure (HF) outcomes.
To investigate the effects of social support among patients with HF, we examined whether aspects of social support were associated with self-care, including medication adherence, dietary adherence, and HF symptom monitoring functions.
We recruited 74 patients with HF from cardiology clinics of a Veterans Affairs Medical Center and a university-affiliated hospital, and tested the relationships between social support and the patients' self-care.
Consistent with previous research in older adults, family members, especially spouses, were often involved in the medical care of patients with chronic HF and provided a range of levels of support to patients. Self-care was generally poor, as measured across several self-care domains. Perceived social support was moderately associated with relatively better self-reported medication and dietary adherence, and other aspects of self-care such as daily weighing.
These findings suggest that a relatively higher level of self-care is an important correlate of social support and may explain how social support influences HF outcomes. This study also suggests that family members should play a greater part in clinical care focused on improving self-care.
社会支持会影响慢性病患者的治疗依从性,这或许可以解释社会支持对心力衰竭(HF)治疗效果产生积极影响的原因。
为了研究社会支持对心力衰竭患者的影响,我们调查了社会支持的各个方面是否与自我护理相关,包括药物依从性、饮食依从性和心力衰竭症状监测功能。
我们从一家退伍军人事务医疗中心和一家大学附属医院的心脏病诊所招募了74名心力衰竭患者,并测试了社会支持与患者自我护理之间的关系。
与先前针对老年人的研究一致,家庭成员,尤其是配偶,经常参与慢性心力衰竭患者的医疗护理,并为患者提供不同程度的支持。从几个自我护理领域的测量结果来看,自我护理总体情况较差。感知到的社会支持与相对较好的自我报告的药物和饮食依从性以及自我护理的其他方面(如每日称重)存在中度关联。
这些发现表明,相对较高水平的自我护理是社会支持的一个重要关联因素,可能解释了社会支持如何影响心力衰竭的治疗效果。这项研究还表明,家庭成员应在专注于改善自我护理的临床护理中发挥更大作用。