Bos-Touwen Irene, Jonkman Nini, Westland Heleen, Schuurmans Marieke, Rutten Frans, de Wit Niek, Trappenburg Jaap
Department Rehabilitation, Nursing Science & Sports, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands,
Curr Heart Fail Rep. 2015 Jun;12(3):223-35. doi: 10.1007/s11897-015-0259-3.
The effectiveness of heart failure (HF) self-management interventions varies within patients suggesting that one size does not fit all. It is expected that effectiveness can be optimized when interventions are tailored to individual patients. The aim of this review was to synthesize the literature on current use of tailoring in self-management interventions and patient characteristics associated with self-management capacity and success of interventions, as building blocks for tailoring. Within available trials, the degree to which interventions are explicitly tailored is marginal and often limited to content. We found that certain patient characteristics that are associated with poor self-management capacity do not influence effectiveness of a given intervention (i.e., age, gender, ethnicity, disease severity, number of comorbidities) and that other characteristics (low: income, literacy, education, baseline self-management capacity) in fact are indicators of patients with a high likelihood for success. Increased scientific efforts are needed to continue unraveling success of self-management interventions and to validate the modifying impact of currently known patient characteristics.
心力衰竭(HF)自我管理干预措施在患者中的效果存在差异,这表明一种方法并不适用于所有患者。预计当干预措施针对个体患者进行调整时,效果可以得到优化。本综述的目的是综合有关当前自我管理干预中个性化调整的应用以及与自我管理能力和干预成功相关的患者特征的文献,作为个性化调整的基础。在现有试验中,干预措施明确个性化的程度微乎其微,且通常仅限于内容方面。我们发现,某些与自我管理能力差相关的患者特征(即年龄、性别、种族、疾病严重程度、合并症数量)不会影响特定干预措施的效果,而其他特征(低:收入、识字率、教育程度、基线自我管理能力)实际上是成功可能性较高的患者的指标。需要加大科学研究力度,以继续揭示自我管理干预措施的成功之处,并验证目前已知的患者特征的调节作用。