心力衰竭患者定期症状监测与自我护理管理之间的关联。
The association between regular symptom monitoring and self-care management in patients with heart failure.
作者信息
Lee Kyoung Suk, Lennie Terry A, Dunbar Sandra B, Pressler Susan J, Heo Seongkum, Song Eun Kyeung, Biddle Martha J, Moser Debra K
机构信息
Kyoung Suk Lee, PhD, RN, MPH Assistant Professor, School of Nursing, University of Wisconsin-Madison. Terry A. Lennie, PhD, RN, FAAN Professor, College of Nursing, University of Kentucky, Lexington. Sandra B. Dunbar, DSN, RN Professor, School of Nursing, Emory University, Atlanta, Georgia. Susan J. Pressler, PhD, RN Professor, School of Nursing, University of Michigan, Ann Arbor. Seongkum Heo, PhD, RN Assistant Professor, College of Nursing, University of Arkansas for Medical Sciences, Little Rock. Eun Kyeung Song, PhD, RN Assistant Professor, College of Medicine, Department of Nursing, University of Ulsan, South Korea. Martha J. Biddle, PhD, APRN Assistant Professor, College of Nursing, University of Kentucky, Lexington. Debra K. Moser, DNSc, RN, FAAN Professor and Gill Endowed Chair of Nursing, College of Nursing, University of Kentucky, Lexington.
出版信息
J Cardiovasc Nurs. 2015 Mar-Apr;30(2):145-51. doi: 10.1097/JCN.0000000000000128.
BACKGROUND
Symptom monitoring is considered the first step toward self-care management (actions to manage altered symptom status) to avert worsening heart failure (HF). However, empirical evidence demonstrating that symptom monitoring leads to adequate self-care management is lacking. We examined the relationship of adherence to regular symptom monitoring with adequate self-care management in HF patients.
METHODS AND RESULTS
A total of 311 HF patients (60 years, 35% women) were divided into 3 groups by adherence to 2 symptom monitoring behaviors (monitoring daily weights and lower extremity edema). Patients who were adherent to both symptom monitoring behaviors formed the adherent group (15.1%). Those adherent to either of the symptom monitoring behaviors formed the partially adherent group (28.9%). Those adherent to neither of the symptom monitoring behaviors formed the nonadherent group (56.0%). The adjusted odds of performing adequate self-care management were increased by 225% (95% confidence interval, 1.13-4.48) and 344% (95% confidence interval, 1.55-7.62) for the partially adherent and adherent symptom monitoring groups, respectively, compared with the nonadherent group.
CONCLUSION
Adequacy of self-care management was predicted by adherence to symptom monitoring behaviors. This finding suggests that regular symptom monitoring facilitates performance of adequate self-care management, which may contribute to a decrease in preventable hospitalizations in HF.
背景
症状监测被认为是自我护理管理（管理症状状态改变的行为）以避免心力衰竭（HF）恶化的第一步。然而，缺乏实证证据表明症状监测能导致充分的自我护理管理。我们研究了HF患者坚持定期症状监测与充分自我护理管理之间的关系。
方法与结果
总共311例HF患者（年龄60岁，35%为女性）根据对两种症状监测行为（每日监测体重和下肢水肿）的坚持情况分为3组。坚持两种症状监测行为的患者组成坚持组（15.1%）。坚持其中一种症状监测行为的患者组成部分坚持组（28.9%）。两种症状监测行为都不坚持的患者组成不坚持组（56.0%）。与不坚持组相比，部分坚持和坚持症状监测组进行充分自我护理管理的调整后比值分别增加了225%（95%置信区间，1.13 - 4.48）和344%（95%置信区间，1.55 - 7.62）。
结论
坚持症状监测行为可预测自我护理管理的充分性。这一发现表明，定期症状监测有助于进行充分的自我护理管理，这可能有助于减少HF患者可预防的住院次数。
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