Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, PO Box 123 Broadway NSW 2007, Australia.
Eur J Cardiovasc Nurs. 2010 Sep;9(3):153-60. doi: 10.1016/j.ejcnurse.2009.12.006. Epub 2010 Jan 25.
Regular symptom monitoring enables early detection and treatment of heart failure exacerbations, reducing preventable hospital admissions.
To determine the level of self management and frequency of symptom monitoring and factors associated in patients with moderate severity HF living in the community.
A correlation study of a convenience sample of patients recently admitted or enrolled in treatment for heart failure were interviewed twice, one month apart, on self management and the frequency of monitoring five key heart failure symptoms.
Participants (n=63) had an age mean of 78.38 years (SD 8.54 years), and approximately half were male (57%) and married (56%). Daily monitoring occurred in 69.8% for peripheral oedema, 65% for weight and 41.3% for fatigue, 38.9% for dyspnea during normal activity and 28.6% for dyspnea at night or at rest. At baseline, better self management was predicted by more comorbid conditions (ss=-2.64) and stronger sense of coherence (ss=-0.24), and one month later, by the baseline self management score (ss=.65). The only predictor of symptom monitoring at one month was the frequency of monitoring at baseline (OR=9.18).
Neither self management nor symptom monitoring is ideal in people with HF. As these behaviours did not change with time, interventions are needed early in the illness course.
定期监测症状可早期发现和治疗心力衰竭恶化，减少可预防的住院。
确定具有中度严重心力衰竭且居住在社区中的患者的自我管理水平和症状监测频率及其相关因素。
对最近因心力衰竭入院或接受治疗的患者的便利样本进行相关性研究，患者在相隔一个月的两次访谈中接受自我管理和监测五个关键心力衰竭症状的频率。
参与者（n=63）的年龄平均为 78.38 岁（SD 8.54 岁），约一半为男性（57%）和已婚（56%）。日常监测外周水肿发生率为 69.8%，体重为 65%，疲劳为 41.3%，正常活动时呼吸困难为 38.9%，夜间或休息时呼吸困难为 28.6%。基线时，更多的合并症（ss=-2.64）和更强的应对感（ss=-0.24）预测自我管理更好，一个月后，由基线自我管理评分预测（ss=.65）。一个月后监测症状的唯一预测因素是基线监测频率（OR=9.18）。
心力衰竭患者的自我管理和症状监测均不理想。由于这些行为并没有随时间而改变，因此需要在疾病早期进行干预。
