Zhang Karen M, Dindoff Kathleen, Arnold J Malcolm O, Lane Jeanine, Swartzman Leora C
Department of Psychology, University of Western Ontario, London, ON, Canada.
School of Language & Liberal Studies, Fanshawe College, London, ON, Canada.
Patient Educ Couns. 2015 Aug;98(8):927-34. doi: 10.1016/j.pec.2015.04.011. Epub 2015 Apr 27.
To describe the life goals of heart failure (HF) patients and to determine whether adherence is influenced by the extent to which these priorities are perceived as compatible with HF self-care regimens.
Forty HF outpatients identified their top-five life goals and indicated the compatibility of HF self-care regimens (diet, exercise, weighing) with these priorities. HF knowledge, self-efficacy and reported adherence were also assessed.
Patients valued autonomy and social relationships as much as physical health. However, the rated importance of these domains did not predict adherence. Adherence positively correlated with the extent to which the regimen, specifically exercise, was considered compatible with life goals (r=.34, p<.05). Exercise adherence also correlated with illness severity and self-efficacy (rs=-.42 and .36, p<.05, respectively). The perceived compatibility of physical activity with personal goals predicted 11% of the variance in exercise adherence above and beyond that accounted for by illness severity and self-efficacy (FΔ (1, 36)=7.11, p<.05).
Patients' goals outside of the illness management context influence self-care practices.
Exploring patients' broad life goals may increase opportunities to resolve ambivalence and enhance motivation for self-care adherence.
描述心力衰竭（HF）患者的生活目标，并确定这些优先事项被认为与HF自我护理方案的兼容程度是否会影响依从性。
40名HF门诊患者确定了他们的前五项生活目标，并指出HF自我护理方案（饮食、运动、称重）与这些优先事项的兼容性。还评估了HF知识、自我效能感和报告的依从性。
患者对自主性和社会关系的重视程度与身体健康相当。然而，这些领域的重要性评分并不能预测依从性。依从性与方案（特别是运动）被认为与生活目标的兼容程度呈正相关（r = 0.34，p < 0.05）。运动依从性也与疾病严重程度和自我效能感相关（rs分别为 - 0.42和0.36，p < 0.05）。身体活动与个人目标的感知兼容性预测了运动依从性变异的11%，超出了疾病严重程度和自我效能感所解释的变异（FΔ(1, 36) = 7.11，p < 0.05）。
疾病管理背景之外的患者目标会影响自我护理行为。
探索患者广泛的生活目标可能会增加解决矛盾心理的机会，并增强自我护理依从性的动机。
