Philips Research, Eindhoven, The Netherlands.
Heart Fail Rev. 2012 May;17(3):367-85. doi: 10.1007/s10741-011-9292-9.
Self-care is an important aspect of heart failure (HF) management. Information on the determinants of self-care is necessary for the development of self-care promotion interventions. HF self-care includes self-care management, self-care maintenance, sodium, fluid and alcohol intake restriction, physical activity, smoking cessation, monitoring signs and symptoms and keeping follow-up appointments. To assess the evidence regarding presumed determinants of HF self-care and make recommendations for interventions to promote self-care behavior among HF patients, a systematic literature review was conducted. Based on inclusion and exclusion criteria and a quality assessment, twenty-six articles were included. A best evidence synthesis was used. Results showed that the length of time since patients' diagnosis with HF is positively related to their performance of self-care maintenance. Moreover, it was found that HF patients' perceived benefits and barriers are related to their restriction of sodium intake, and that patients with type-D personality are less likely to consult medical professionals. There was also evidence for a few non-significant relationships. All other evidence was inconsistent, mainly due to insufficient evidence. Interventions that aim to increase the performance of self-care maintenance can teach newly diagnosed patients the skills that are usually attained with experience acquired as a result of living with HF for a longer time. Perceived benefits and barriers of restricting sodium intake could be targeted in interventions for sodium intake reduction among HF patients. Finally, interventions for the promotion of adequate consulting of medical professionals can specifically target HF patients with a type-D personality.
自我护理是心力衰竭（HF）管理的一个重要方面。了解自我护理的决定因素对于开发自我护理促进干预措施是必要的。HF 自我护理包括自我护理管理、自我护理维持、钠、液体和酒精摄入限制、身体活动、戒烟、监测体征和症状以及保持随访预约。为了评估 HF 自我护理的假定决定因素的证据，并为促进 HF 患者自我护理行为的干预措施提出建议，进行了系统的文献回顾。根据纳入和排除标准以及质量评估，纳入了 26 篇文章。使用最佳证据综合。结果表明，患者 HF 诊断后的时间长短与他们的自我护理维持表现呈正相关。此外，还发现 HF 患者的感知益处和障碍与他们的钠摄入量限制有关，而具有 D 型人格的患者不太可能咨询医疗专业人员。还有一些非显著关系的证据。所有其他证据都是不一致的，主要是由于证据不足。旨在提高自我护理维持表现的干预措施可以教授新诊断的患者通常通过随着时间的推移因患有 HF 而获得的经验获得的技能。限制钠摄入量的感知益处和障碍可以作为 HF 患者钠摄入量减少干预措施的目标。最后，促进充分咨询医疗专业人员的干预措施可以专门针对具有 D 型人格的 HF 患者。
