心力衰竭：护理与治疗工具。

Heart failure: tools for nursing and medical treatment.

机构信息

Department of Internal Medicine and Public Health, University of L'Aquila, Ospedale S. Salvatore Delta 6, Coppito AQ, Italy.

出版信息

Cardiol J. 2011;18(4):411-20.

PMID:21769822

Abstract

BACKGROUND

To validate a structured interview designed to evaluate the healthcare and information needs of patients with heart failure (HF), who were also characterized by means of the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the 36-item Short-Form Health Survey (SF-36).

METHODS

Forty-five in- and outpatients with HF were administered a structured interview concerning their information and healthcare needs (together with the KCCQ and SF-36) with the aim of investigating the effects of healthcare models on their quality of life (QoL). Twenty-one patients were also involved in a one-week test-retest validity study carried out in order to verify reproducibility and stability by means of concordance and K statistics.

RESULTS

The reproducibility of the structured interview was good or very good for all items, with a mean Kw of 0.59; the clarity and acceptability of most of the questions were good. Positive judgements of hospital care inversely related to the patients' New York Heart Association class. The subjects about which the patients sought greater information were diet, sleep, therapies and physical exercise, with cardiologists and general practitioners (GPs) being more involved than nurses. The most frequently discussed subject was diagnostic examinations. The questionnaire scores of our patients were generally lower than those reported in the literature, possibly because of their advanced age. However, it is difficult to believe that the quality of care was extraneous to their generally worse health-related QoL.

CONCLUSIONS

Our HF patients experienced a 'basic' healthcare model (hospitals, GPs, cardiologists) and judged them acceptable. Their ability to think critically about care was increasingly compromised as HF progressed and their health-related QoL decreased.

摘要

背景

为了验证一项旨在评估心力衰竭（HF）患者医疗和信息需求的结构化访谈，该访谈还通过堪萨斯城心肌病问卷（KCCQ）和 36 项简短健康调查（SF-36）对患者进行了特征描述。

方法

对 45 名住院和门诊 HF 患者进行了一项结构化访谈，内容涉及他们的信息和医疗需求（以及 KCCQ 和 SF-36），目的是研究医疗模式对其生活质量（QoL）的影响。为了验证一致性和 K 统计数据的可重复性和稳定性，还对 21 名患者进行了为期一周的重测有效性研究。

结果

结构化访谈的可重复性对于所有项目都是良好或非常好，平均 Kw 为 0.59；大多数问题的清晰度和可接受性都很好。对医院护理的积极评价与患者的纽约心脏协会（NYHA）分级呈反比。患者寻求更多信息的对象是饮食、睡眠、治疗和体育锻炼，与护士相比，心脏病专家和全科医生（GP）参与度更高。讨论最多的主题是诊断检查。与文献报道相比，我们患者的问卷评分普遍较低，这可能是由于他们年龄较大。然而，很难相信护理质量与他们普遍较差的健康相关 QoL 无关。