Albert Nancy M, Cohen Bonni, Liu Xiaobo, Best Carolyn H, Aspinwall Laura, Pratt Lisa
Cleveland Clinic, USA
Valdosta State University College of Nursing, USA.
Eur J Cardiovasc Nurs. 2015 Oct;14(5):431-40. doi: 10.1177/1474515114540756. Epub 2014 Jun 16.
Nurses are expected to deliver pre-discharge heart failure education in 8 content areas: what heart failure means, medications, diet, activity, weight monitoring, fluid restriction, signs/symptoms of worsening condition and signs/symptoms of fluid overload.
To examine nurses' comfort in and frequency of delivering heart failure education to hospitalized patients.
A multicenter, descriptive, correlational design and questionnaire methods were used. General linear models were performed to assess associations of comfort in and frequency of delivering patient education after controlling for significant nurse characteristics.
Of 118 nurses, mean age was 39 ± 11.6 years, 61.9% worked on cardiac units and 58.3% spent <15 min providing pre-discharge heart failure education. Comfort in delivering education was highest for weight monitoring and lowest for activity, and was associated with nurse age (p=0.019), years in profession (p=0.004) and minutes providing pre-discharge education (p=0.003). Frequency delivering education was highest for signs/symptoms of worsening condition (mean frequency, 71.5% ± 29%) and lowest for activity (42.7% ± 29.4%) and was associated with comfort in educating patients (all p<0.001); and pre-discharge education minutes, p<0.001. Using general linear modeling, minutes spent delivering pre-discharge education remained associated with overall comfort in (p=0.04) and frequency of (p<0.001) heart failure education delivery.
Nurses' comfort in and frequency of delivering education varied by heart failure self-care content area. Self-care education areas most important to survival and hospitalization had the lowest rates of nurse comfort and frequency. Systems and processes are needed to facilitate education delivery prior to hospital discharge.
护士应在出院前提供8个内容领域的心力衰竭教育:心力衰竭的含义、药物治疗、饮食、活动、体重监测、液体限制、病情恶化的体征/症状以及液体过载的体征/症状。
研究护士对住院患者进行心力衰竭教育时的舒适度及频率。
采用多中心、描述性、相关性设计及问卷调查方法。在控制重要的护士特征后,使用一般线性模型评估提供患者教育的舒适度及频率之间的关联。
118名护士中,平均年龄为39±11.6岁,61.9%在心脏科工作,58.3%在出院前提供心力衰竭教育的时间少于15分钟。提供教育的舒适度在体重监测方面最高,在活动方面最低,且与护士年龄(p=0.019)、工作年限(p=0.004)及出院前教育时间(p=0.003)相关。教育频率在病情恶化的体征/症状方面最高(平均频率为71.5%±29%),在活动方面最低(42.7%±29.4%),且与教育患者的舒适度(所有p<0.001)及出院前教育时间(p<0.001)相关。使用一般线性模型,出院前教育花费的时间仍与心力衰竭教育提供的总体舒适度(p=0.04)及频率(p<0.001)相关。
护士在不同心力衰竭自我护理内容领域提供教育的舒适度和频率各不相同。对生存和住院最重要的自我护理教育领域,护士的舒适度和频率最低。需要建立系统和流程以促进出院前的教育提供。