Spaling Melisa A, Currie Kay, Strachan Patricia H, Harkness Karen, Clark Alexander M
University of Alberta, Edmonton, Alberta, Canada.
Glasgow Caledonian University, Scotland, UK.
J Adv Nurs. 2015 Nov;71(11):2478-89. doi: 10.1111/jan.12712. Epub 2015 Jun 18.
This systematic review aimed to generate patient-focussed recommendations to enhance support of heart failure self-care by examining patients' experiences, perspectives and self-care behaviours.
Despite increased recognition of the importance of heart failure self-care, patients' knowledge and practices around this self-care and interventions to improve it are inconsistent. Consequently, current guidelines focus on what the domains of heart failure self-care are, more so than the ways to improve this care.
Systematic review and qualitative interpretive synthesis.
A systematic, comprehensive and detailed search of 11 databases was conducted until March, 2012 for papers published 1995-2012: 37 studies were included (1343 patients, 75 caregivers, 63 health care professionals) that contained a qualitative research component and data on adult patients' heart failure self-care.
This interpretive synthesis used a recognized approach consisting of a multi-stage analytic process; in addition, the included studies underwent quality appraisal.
Findings indicate that while patients could often recall health professionals' self-care advice, they were unable to integrate this knowledge into daily life. Attempts to manage HF were based on how patients 'felt' rather than clinical indicators of worsening symptoms. Self-efficacy and learning from past management experiences facilitated favourable outcomes - these enabled patients and caregivers to adeptly apply self-care strategies into daily activities.
Addressing common but basic knowledge misconceptions regarding the domains of HF self-care is insufficient to increase effective HF self-care; this should be supplemented with strategies with patients and family members to promote self-efficacy, learning and adaptation/application of recommendations to daily life.
本系统评价旨在通过研究患者的经历、观点和自我护理行为，生成以患者为中心的建议，以加强对心力衰竭自我护理的支持。
尽管人们越来越认识到心力衰竭自我护理的重要性，但患者关于这种自我护理的知识和实践以及改善它的干预措施并不一致。因此，当前指南更多地关注心力衰竭自我护理的领域是什么，而不是改善这种护理的方法。
系统评价和定性解释性综合。
对11个数据库进行了系统、全面和详细的检索，直至2012年3月，检索1995 - 2012年发表的论文：纳入了37项研究（1343名患者、75名护理人员、63名医疗保健专业人员），这些研究包含定性研究部分以及关于成年患者心力衰竭自我护理的数据。
这种解释性综合采用了一种公认的方法，包括多阶段分析过程；此外，对纳入的研究进行了质量评估。
研究结果表明，虽然患者通常能够回忆起医疗保健专业人员的自我护理建议，但他们无法将这些知识融入日常生活。管理心力衰竭的尝试基于患者的“感觉”，而不是症状恶化的临床指标。自我效能感和从过去的管理经验中学习促进了良好的结果——这些使患者和护理人员能够熟练地将自我护理策略应用于日常活动。
解决关于心力衰竭自我护理领域常见但基本的知识误解不足以提高有效的心力衰竭自我护理；这应该辅以与患者和家庭成员的策略，以促进自我效能感、学习以及将建议应用和适应于日常生活。
Zotero 插件