Shim Jae Lan, Hwang Seon Young
School of Nursing, Hanyang University, Seoul, Korea.
J Korean Acad Nurs. 2016 Dec;46(6):881-893. doi: 10.4040/jkan.2016.46.6.881.
The purpose of this study was to develop a heart health diary to promote self-care ability among patients with heart failure (HF), and to identify the diary's effect on self-care adherence, self-efficacy, and physical activity.
A randomized control-group pretestposttest design was adopted using block randomization. A calender-typed health diary was developed and it included a self-care checklist and education information on HF management. The experimental group were given guided counseling and education for 8 weeks and wrote a daily health diary during that period. Data were collected from the outpatient department of a tertiary medical center from February to April 2016. To verify the hypotheses, data for the experimental group (n=28) and control group (n=33) were analysed using the independent t-test with SPSS/WIN 21.0.
At the end of 8 weeks the experimental group had significantly higher scores for self-care adherence (t=-2.48, p=.016) and exercise related self-efficacy (t=-3.44, p=.001) compared to the control group.
The findings show that the application of a patient-directed heart health diary is an effective nursing intervention for improving HF patients' self-care adherence and exercise self-efficacy. Strategies to promote dietary self-efficacy are necessary along with further studies including repeated research with an increasing intervention period. Healthcare providers need to encourage the utilization of a health diary for HF patients as a tool for evaluation and for implementation that leads to self-care.
本研究旨在开发一种心脏健康日记,以提高心力衰竭(HF)患者的自我护理能力,并确定该日记对自我护理依从性、自我效能感和身体活动的影响。
采用随机对照组前测后测设计,采用区组随机化。开发了一种日历式健康日记,其中包括自我护理清单和关于HF管理的教育信息。实验组接受了为期8周的指导咨询和教育,并在此期间每天撰写健康日记。2016年2月至4月从一家三级医疗中心的门诊部收集数据。为验证假设,使用SPSS/WIN 21.0对实验组(n = 28)和对照组(n = 33)的数据进行独立t检验分析。
8周结束时,与对照组相比,实验组的自我护理依从性(t = -2.48,p = 0.016)和运动相关自我效能感(t = -3.44,p = 0.001)得分显著更高。
研究结果表明,应用以患者为导向的心脏健康日记是一种有效的护理干预措施,可提高HF患者的自我护理依从性和运动自我效能感。除了进一步研究,包括延长干预期的重复研究外,还需要促进饮食自我效能感的策略。医疗保健提供者需要鼓励HF患者使用健康日记作为评估和实施自我护理的工具。