Liu Min-Hui, Wang Chao-Hung, Huang Yu-Yen, Cherng Wen-Jin, Wang Kai-Wei Katherine
1MSN, RN, Case Manager, Heart Failure Center, Keelung Chang-Gung Memorial Hospital, and Doctoral Student, School of Nursing, National Yang-Ming University 2PhD, MD, Director, Heart Failure Center, Keelung Chang Gung Memorial Hospital, and Professor, College of Medicine, Chang Gung University 3RN, Heart Failure Center, Keelung Chang Gung Memorial Hospital 4MD, Superintendent, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, and Professor, College of Medicine, Chang Gung University 5PhD, RN, Assistant Professor, School of Nursing, National Yang-Ming University.
J Nurs Res. 2014 Jun;22(2):136-45. doi: 10.1097/JNR.0000000000000024.
Patients with heart failure experience adverse physical symptoms that affect quality of life. The number of patients with heart failure in Taiwan has been growing in recent years.
This article examines correlations among illness knowledge, self-care behaviors, and quality of life in elderly patients with heart failure.
A cross-sectional research design using three questionnaires was adopted. The study was undertaken in an outpatient department of a teaching hospital in Taiwan from January to June 2008. Potential participants aged 65 years or older were selected by a physician based on several diagnostic findings of heart failure that included an International Classification of Diseases' code 4280 or 4289. Patients who were bedridden or had a prognosis of less than 6 months were excluded from consideration.
One hundred forty-one patients with heart failure were recruited. Most participants were men (51.8%), older adults (49.6% older than 71 years old), and either educated to an elementary school level or illiterate (69.5%) and have New York Heart Association class II (61.0%). Participants had an average left ventricular ejection fraction of 41.1%. The illness knowledge of participants was poor (accuracy rate: 29.3%), and most were unaware of the significance of self-care. Illness knowledge correlated with both self-care behaviors (r = -.42, p < .01) and quality of life (r = -.22, p < .01). Illness knowledge and age were identified as significant correlated factors of self-care behaviors (R = .22); and functional class, living independently, and age were identified as significant correlated factors of quality of life (R = .41).
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Participants in this study with higher self-reported self-care behaviors and quality of life were younger in age and had better illness knowledge. Furthermore, physical function and independence in daily living significantly affected quality of life. Care for patients with heart failure, particularly older adults, should focus on teaching these patients about heart failure illness and symptom management. Assisting elderly patients with heart failure to promote and maintain physical functions to handle activities of daily living independently is critical to improving patient quality of life.
心力衰竭患者会经历影响生活质量的不良身体症状。近年来,台湾心力衰竭患者的数量一直在增加。
本文探讨老年心力衰竭患者的疾病知识、自我护理行为和生活质量之间的相关性。
采用横断面研究设计,使用三份问卷。该研究于2008年1月至6月在台湾一家教学医院的门诊部进行。65岁及以上的潜在参与者由医生根据心力衰竭的多项诊断结果进行选择,这些结果包括国际疾病分类代码4280或4289。卧床不起或预后少于6个月的患者被排除在外。
招募了141名心力衰竭患者。大多数参与者为男性(51.8%),老年人(49.6%年龄大于71岁),小学文化程度或文盲(69.5%),纽约心脏协会心功能分级为II级(61.0%)。参与者的平均左心室射血分数为41.1%。参与者的疾病知识较差(准确率:29.3%),大多数人未意识到自我护理的重要性。疾病知识与自我护理行为(r = -0.42,p < 0.01)和生活质量(r = -0.22,p < 0.01)均相关。疾病知识和年龄被确定为自我护理行为的显著相关因素(R = 0.22);功能分级、独立生活和年龄被确定为生活质量的显著相关因素(R = 0.41)。
结论/对实践的启示:本研究中自我报告的自我护理行为和生活质量较高的参与者年龄较轻且疾病知识较好。此外,身体功能和日常生活独立性显著影响生活质量。对心力衰竭患者,尤其是老年人的护理应侧重于向这些患者传授心力衰竭疾病和症状管理知识。协助老年心力衰竭患者促进并维持身体功能以独立处理日常生活活动对提高患者生活质量至关重要。