College of Nursing, Villanova University, Pennsylvania, USA.
J Cardiovasc Nurs. 2013 Jul-Aug;28(4):348-59. doi: 10.1097/JCN.0b013e3182531cf7.
Heart failure (HF) is a chronic illness affecting more than 5 million Americans, and it continues to lead healthcare-related expenditures in the United States. Hospitalization rates remain high and are caused by many factors, including poor self-care behaviors. Self-care research is growing, and a situation-specific theory for the HF population is now published. Self-care management, which is part of self-care, includes a series of responses and actions that the individual living with HF assumes in response to a change in baseline health. A critical aspect of enacting a self-care management plan is the ability to recognize changes in baseline health as being related to HF.
This integrative review examined research to date on self-reported patterns of symptom recognition, an antecedent to self-care management, and treatment-seeking behaviors in HF patients.
Descriptive research strategies were predominantly used to examine symptom recognition, interpretation, and response in HF patients. Seven studies used retrospective approaches, such as chart review or patient recall, to collect data, and 7 studies collected data from the patient prospectively. The quantitative portion of 2 mixed-methods study was also analyzed. Dyspnea was the most frequently reported symptom across all studies reviewed. Dyspnea was characterized in terms of duration and was defined inconsistently across studies. In some studies, duration of dyspnea was associated with treatment-seeking delays. Elderly patients and newly diagnosed HF patients are more likely to delay treatment seeking for onset of symptoms.
Research is limited on symptom recognition and treatment-seeking behaviors in HF patients. Evidence suggests that symptom recognition may be impaired in the elderly population. Research studies to date on symptom recognition have largely been descriptive; no studies in this review followed patients' ability to recognize and respond to symptoms prospectively in their home environment. Symptoms may vary and their pattern may influence patients' recognition and/or response patterns.
心力衰竭（HF）是一种影响超过 500 万美国人的慢性疾病，它继续导致美国与医疗保健相关的支出。住院率仍然很高，这是由多种因素造成的，包括自我护理行为不佳。自我护理研究正在不断发展，现在已经为 HF 患者发布了一种特定于情况的理论。自我护理管理是自我护理的一部分，包括个体在基础健康状况发生变化时采取的一系列应对和行动。实施自我护理管理计划的一个关键方面是能够识别与 HF 相关的基础健康变化。
本次综合回顾审查了迄今为止关于 HF 患者自我报告的症状识别模式、自我护理管理的前因以及治疗寻求行为的研究。
描述性研究策略主要用于检查 HF 患者的症状识别、解释和反应。七项研究使用回顾性方法（如图表审查或患者回忆）收集数据，七项研究前瞻性地从患者收集数据。两项混合方法研究的定量部分也进行了分析。呼吸困难是所有审查研究中报告最频繁的症状。呼吸困难在不同的研究中以不同的方式描述其持续时间且定义不一致。在一些研究中，呼吸困难的持续时间与治疗寻求延迟有关。老年患者和新诊断的 HF 患者更有可能因症状发作而延迟治疗。
关于 HF 患者的症状识别和治疗寻求行为的研究有限。有证据表明，老年人的症状识别可能受损。迄今为止，关于症状识别的研究主要是描述性的；本综述中的研究没有一项在患者的家庭环境中前瞻性地跟踪他们识别和应对症状的能力。症状可能会有所不同，其模式可能会影响患者的识别和/或反应模式。
