Department of Cardiac Surgery, Northwestern Memorial Hospital, Chicago, IL, USA.
J Cardiovasc Nurs. 2010 Jan-Feb;25(1):7-12. doi: 10.1097/JCN.0b013e3181b7af9e.
Heart failure (HF) is a costly and highly disabling syndrome affecting nearly 5 million individuals yearly. Lifestyle changes are crucial to the successful management of HF, and daily weight monitoring is an essential component of self-care. Daily weights provide an objective indicator of fluid volume status in patients with HF. However, the practice of performing daily weights is underappreciated and infrequently implemented by patients. This may contribute to an inability to recognize worsening HF and, ultimately, delay in seeking medical care.
The aim of this study was to evaluate weight monitoring diaries for adherence to daily weight monitoring, reasons for nonadherence, prevalence of weight gain of 3 lb or more in 1 day, and medical advice-seeking behavior after weight gain in a sample of patients with documented HF.
A cohort study design was used to analyze data from 20 HF patients who participated in a tailored, one-on-one educational intervention. The analysis is part of a parent pilot study designed to improve symptom recognition and response to symptoms of fluid overload. Diary data were collected for 3 months after the intervention. The diaries provided information regarding symptoms that participants experienced, daily weights, and a record of unplanned hospital visits or contacts with their physician.
Of 20 participants in the study, 16 returned diaries for analysis. Two participants withdrew participation before the conclusion of the study and 2 participants who claimed to have completed their diary never returned the diary despite repeated reminders and telephone calls. Sixteen participant diaries were therefore available for analysis. The mean adherence score for these 16 participants was 79.4%. Seventy-five percent had weight gains of 3 lb or more in 1 day and only 1 person contacted his/her physician for weight gain. Vacation time was the most common reason for weighing nonadherence.
This study revealed high adherence to daily weights in patients receiving an education session focused on fluid weight management. However, behavior related to daily weights did not lead to more appropriate use of physician or provider consultation. Diaries offer promise for symptom management and an opportunity for patients to engage in self-care; however, clinicians need to encourage patients to use the diary data to seek prompt medical care.
心力衰竭（HF）是一种每年影响近 500 万人的昂贵且高度致残的综合征。生活方式的改变对于 HF 的成功管理至关重要，而日常体重监测是自我护理的重要组成部分。每日体重提供了 HF 患者液体量状态的客观指标。然而，患者对日常体重监测的重视程度不足，且实施频率较低。这可能导致无法识别 HF 恶化，并最终延迟寻求医疗护理。
本研究旨在评估体重监测日记在遵守每日体重监测、不遵守的原因、1 天体重增加 3 磅或以上的发生率，以及在有记录的 HF 患者样本中体重增加后寻求医疗建议的行为。
使用队列研究设计分析了 20 名参与定制一对一教育干预的 HF 患者的数据。该分析是旨在改善症状识别和对液体超负荷症状反应的母试验的一部分。干预后收集了 3 个月的日记数据。日记提供了参与者经历的症状、每日体重以及非计划住院或与医生联系的记录。
在 20 名研究参与者中，有 16 名返回了日记进行分析。2 名参与者在研究结束前退出了研究，2 名声称完成了日记的参与者尽管反复提醒和电话联系，但从未返回日记。因此，16 名参与者的日记可供分析。这 16 名参与者的平均依从性评分为 79.4%。75%的人在 1 天内体重增加了 3 磅或更多，只有 1 人因体重增加而联系了他/她的医生。休假时间是最常见的不称重原因。
这项研究表明，接受以液体体重管理为重点的教育课程的患者对每日体重的依从性很高。然而，与每日体重相关的行为并未导致更适当的使用医生或医疗服务提供者咨询。日记为症状管理提供了希望，为患者参与自我护理提供了机会；然而，临床医生需要鼓励患者使用日记数据寻求及时的医疗护理。
