Kelly L. Wierenga, PhD, RN Postdoctoral Fellow, Case Western Reserve University, Cleveland, Ohio.
J Cardiovasc Nurs. 2017 Nov/Dec;32(6):594-602. doi: 10.1097/JCN.0000000000000403.
African American women with heart failure (HF) have stressors that negatively impact HF self-management adherence and heighten the occurrence of negative cardiac health events. Perceptions of illness coherence and controllability and emotion regulation are known to facilitate self-management in the face of stressors.
The aim of this study was to determine whether difficulties with emotion regulation and negative perceptions of illness coherence and controllability are detrimental to adherence and increase negative cardiac health events in this patient population.
African American women (n = 54) with HF, aged 49 to 84 years, participated in this longitudinal descriptive correlational study. Using convenience sampling, we recruited patients from hospitals and HF clinics. They completed interviews at intake and 30 days, and their medical records were reviewed at 90 days. Linear and logistic regression models were used to assess predictors of general adherence and negative cardiac health events.
Of 54 patients who participated in the study, 28 experienced a negative health event during 90 days, and 57% of these events were cardiac related. The only clear predictor of these events was greater New York Heart Association functional classification (β = 1.47, P = .027). No associations were found between predictors (emotion regulation, controllability, coherence, age, education) and general adherence.
Emotion regulation showed a possible greater impact on negative cardiac health events than on general adherence. Perceived illness coherence showed less impact on negative cardiac health events than on general adherence.
心力衰竭（HF）的非裔美国女性面临着各种压力源，这些压力源会对 HF 自我管理的依从性产生负面影响，并增加负面心脏健康事件的发生。人们已知，对疾病的一致性和可控性的感知以及情绪调节能力有助于在面对压力源时进行自我管理。
本研究旨在确定情绪调节困难以及对疾病一致性和可控性的负面感知是否会对该患者群体的依从性产生不利影响并增加负面心脏健康事件。
本纵向描述性相关性研究纳入了 54 名年龄在 49 至 84 岁之间的非裔美国 HF 女性患者。我们采用便利抽样法从医院和 HF 诊所招募患者。他们在入组时和第 30 天接受了访谈，并在第 90 天查看了他们的医疗记录。线性和逻辑回归模型用于评估一般依从性和负面心脏健康事件的预测因素。
在参加研究的 54 名患者中，有 28 名在 90 天内发生了负面健康事件，其中 57%的事件与心脏有关。唯一明确预测这些事件的因素是纽约心脏协会（NYHA）功能分类更高（β=1.47，P=0.027）。在预测因素（情绪调节、可控性、一致性、年龄、教育）与一般依从性之间未发现任何关联。
情绪调节对负面心脏健康事件的影响可能大于对一般依从性的影响。对疾病一致性的感知对负面心脏健康事件的影响小于对一般依从性的影响。
