Kennedy Betty M, Jaligam Vijayendra, Conish Beverly K, Johnson William D, Melancon Brian, Katzmarzyk Peter T
Pennington Biomedical Research Center, Baton Rouge, LA.
School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA.
Ochsner J. 2017 Spring;17(1):93-102.
Heart failure (HF) is an incurable and frequently progressive disease. Symptoms of HF may impair the ability of patients to perform daily living activities. As HF progresses, patients typically increase their reliance on caregivers. The purpose of this study was to determine what roles patients and caregivers perceive and desire for themselves in managing HF and to compare and contrast these roles with those perceived by healthcare providers.
A purposive sample (60 patients, 22 caregivers, and 11 healthcare providers) was enrolled in the study. Patients and caregivers individually participated in semistructured interviews, and healthcare providers participated in 1 of 2 focus groups.
Four key themes evolved from interviews with patients and caregivers-education on disease specifics, guidance to enhance quality of life, learning to cope with HF, and future outlook and care decisions-that may guide the development of caregiver interventions in HF. Healthcare providers in both structured focus groups regardless of rank order selected knowledge is powerful, adherence to treatment plan, and compliance with medication as the top 3 issues likely to have the greatest impact, and they identified education on the disease (knowledge is powerful) as the easiest strategy to implement for patients and caregivers in the management of HF.
Interventions among caregivers of patients with HF are needed and should focus on education in family structures, family functioning, and skills training in family assessment and engagement.
心力衰竭(HF)是一种无法治愈且通常会进展的疾病。HF的症状可能会损害患者进行日常生活活动的能力。随着HF的进展,患者通常会增加对护理人员的依赖。本研究的目的是确定患者和护理人员在管理HF方面认为自己应扮演的角色以及期望扮演的角色,并将这些角色与医疗服务提供者所认知的角色进行比较和对照。
本研究纳入了一个有目的的样本(60名患者、22名护理人员和11名医疗服务提供者)。患者和护理人员分别参与半结构化访谈,医疗服务提供者参与两个焦点小组中的一个。
对患者和护理人员的访谈产生了四个关键主题——疾病具体情况的教育、提高生活质量的指导、学会应对HF以及未来展望和护理决策——这些主题可能会指导HF护理人员干预措施的制定。两个结构化焦点小组中的医疗服务提供者,无论排名顺序如何,都选择知识就是力量、坚持治疗计划和遵医嘱服药作为可能产生最大影响的前三大问题,并且他们将疾病教育(知识就是力量)确定为在HF管理中对患者和护理人员最容易实施的策略。
需要对HF患者的护理人员进行干预,并且干预应侧重于家庭结构教育、家庭功能以及家庭评估和参与方面的技能培训。