University of Nebraska Medical Center College of Nursing, Omaha, Nebraska 68198-5330, USA.
J Cardiovasc Nurs. 2011 Mar-Apr;26(2):89-98. doi: 10.1097/JCN.0b013e3181ec1352.
The objective of this study was to identify factors related to disability in heart failure (HF) patients using a modified version of the model of disability proposed by Nagi. The hypothesized relationships among pathology (severity of HF and comorbidity), impairment (dyspnea, fatigue, muscle strength), functional limitation (functional capacity), and disability (modification in instrumental activities of daily living [IADLs]) were assessed as well as the influence of age and sex on pathways to disability.
Using a cross-sectional design, a convenience sample of 48 men and 53 women (mean age, 59.5 years) with New York Heart Association class II-IV was recruited at a HF clinic. Path analyses via Amos revealed that 71% of the variance in modifications in IADLs was explained by the significant predictors of dyspnea (B = .67), functional capacity (B = -.25), and age (B = .19). Dyspnea and comorbidity also had indirect effects on modification in IADLs through functional capacity. Age also had an indirect effect on modification in activities of daily living through functional capacity, and sex had an indirect effect through dyspnea and functional capacity.
Patients with HF may benefit from interventions targeted at reducing dyspnea with daily activities and improving functional capacity to prevent disability.
本研究旨在使用 Nagi 提出的残疾模型的改良版本，确定与心力衰竭（HF）患者残疾相关的因素。假设的病理关系（HF 的严重程度和合并症）、损伤（呼吸困难、疲劳、肌肉力量）、功能限制（功能能力）和残疾（日常活动工具的修改[IADL]）之间的关系以及年龄和性别对残疾途径的影响进行了评估。
采用横断面设计，在 HF 诊所招募了 48 名男性和 53 名女性（平均年龄 59.5 岁），纽约心脏协会（NYHA）II-IV 级。通过 Amos 的路径分析显示，IADL 修改的 71%的方差由呼吸困难（B =.67）、功能能力（B = -.25）和年龄（B =.19）的显著预测因子解释。呼吸困难和合并症也通过功能能力对 IADL 的修改具有间接影响。年龄还通过功能能力对日常生活活动的修改具有间接影响，而性别则通过呼吸困难和功能能力具有间接影响。
HF 患者可能受益于针对减少日常活动中的呼吸困难和提高功能能力以预防残疾的干预措施。
