School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, PA 19104-4217, USA. briegel@ nursing.upenn.edu
Nat Rev Cardiol. 2011 Jul 19;8(11):644-54. doi: 10.1038/nrcardio.2011.95.
'Heart failure self care' refers to the practices in which patients engage to maintain their own health, and to the decisions that they make about managing signs or symptoms. In this article, we base our discussion of self care in chronic heart failure on the classification of patients as being 'expert', inconsistent', or 'novice' in heart failure self-care behaviors. The available literature on factors predicting heart failure self care and its outcomes are reviewed within this context. Factors known to influence heart failure self care include experience with the illness, physical functioning, depression and anxiety, social support, daytime sleepiness, and attitudes such as confidence. Further research is needed to understand the contributions of comorbidities, patient sex, and health disparities on heart failure self care. The evidence to support a link between heart failure self care and health outcomes is limited, but early evidence suggests that adequate self care is associated with an improvement in health status, a decrease in the number and duration of hospitalizations, and a decline in levels of biomarkers of stress and inflammation, and in intrathoracic impedance. Implications of heart failure self care for clinical practice, policy, and public health are also described.
“心力衰竭自我护理”是指患者为保持自身健康而采取的措施，以及他们在管理体征或症状方面所做的决策。在本文中，我们将基于患者在心力衰竭自我护理行为方面被归类为“专家”、“不一致”或“新手”的情况，来讨论慢性心力衰竭的自我护理。在这一背景下，我们对预测心力衰竭自我护理及其结果的相关因素进行了文献回顾。已知影响心力衰竭自我护理的因素包括疾病经历、身体机能、抑郁和焦虑、社会支持、日间嗜睡以及信心等态度。需要进一步的研究来了解合并症、患者性别和健康差异对心力衰竭自我护理的影响。支持心力衰竭自我护理与健康结果之间存在关联的证据有限，但早期证据表明，充分的自我护理与健康状况的改善、住院次数和持续时间的减少、应激和炎症生物标志物水平以及胸腔内阻抗的下降有关。本文还描述了心力衰竭自我护理对临床实践、政策和公共卫生的影响。
