Salvadó-Hernández Cristina, Cosculluela-Torres Pilar, Blanes-Monllor Carmen, Parellada-Esquius Neus, Méndez-Galeano Carmen, Maroto-Villanova Neus, García-Cerdán Rosa Maria, Núñez-Manrique M Pilar, Barrio-Ruiz Carmen, Salvador-González Betlem
ABS Viladecans 1, SAP Delta de Llobregat, DAP Costa de Ponent, Institut Català de la Salut, Viladecans, Barcelona, España; Grupo de investigación MACAP (Malaltia Cardiovascular en Atenció Primària), Costa de Ponent Institut Català de la Salut - Institut d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona, España.
ABS Sant Boi 4 Vinyets, SAP Baix Llobregat Centre, DAP Costa de Ponent, Institut Català de la Salut, Sant Boi de Llobregat, Barcelona, España.
Aten Primaria. 2018 Apr;50(4):213-221. doi: 10.1016/j.aprim.2017.03.008. Epub 2017 Jun 23.
To determine the attitudes, knowledge, and self-care practices in patients with heart failure (HF) in Primary Care, as well as to identify factors associated with better self-care.
Cross-sectional and multicentre study.
Primary Care.
Subjects over 18 years old with HF diagnosis, attended in 10 Primary Health Care Centres in the Metropolitan Area of Barcelona.
Self-care was measured using the European Heart Failure Self-Care Behaviour Scale. Sociodemographic and clinical characteristics, tests on attitudes (Self-efficacy Managing Chronic Disease Scale), knowledge (Patient Knowledge Questionnaire), level of autonomy (Barthel), and anxiety and depression screening (Goldberg Test), were also gathered in an interview. A multivariate mixed model stratified by centre was used to analyse the adjusted association of covariates with self-care.
A total of 295 subjects (77.6%) agreed to participate, with a mean age of 75.6 years (SD: 11), 56.6% women, and 62% with no primary education. The mean self-care score was 28.65 (SD: 8.22), with 25% of patients scoring lower than 21 points. In the final stratified multivariate model (n=282; R conditional=0.3382), better self-care was associated with higher knowledge (coefficient, 95% confidence interval: -1.37; -1.85 to -0.90), and coronary heart disease diagnosis (-2.41; -4.36: -0.46).
Self-care was moderate. The correlation of better self-care with higher knowledge highlights the opportunity to implement strategies to improve self-care, which should consider the characteristics of heart failure patients attended in Primary Care.
确定基层医疗中的心衰（HF）患者的态度、知识和自我护理行为，以及识别与更好的自我护理相关的因素。
横断面多中心研究。
基层医疗。
年龄在18岁以上、被诊断为心衰的患者，来自巴塞罗那大都市区的10个初级卫生保健中心。
使用欧洲心力衰竭自我护理行为量表测量自我护理。在访谈中还收集了社会人口学和临床特征、态度测试（慢性病自我管理效能感量表）、知识（患者知识问卷）、自主水平（巴氏指数）以及焦虑和抑郁筛查（戈德堡测试）。采用按中心分层的多变量混合模型分析协变量与自我护理的校正关联。
共有295名受试者（77.6%）同意参与，平均年龄为75.6岁（标准差：11），56.6%为女性，62%未接受过初等教育。自我护理平均得分为28.65（标准差：8.22），25%的患者得分低于21分。在最终的分层多变量模型（n = 282；条件R = 0.3382）中，更好的自我护理与更高的知识水平（系数，95%置信区间：-1.37；-1.85至-0.90）以及冠心病诊断（-2.41；-4.36：-0.46）相关。
自我护理水平中等。更好的自我护理与更高的知识水平之间的相关性凸显了实施改善自我护理策略的机会，这些策略应考虑基层医疗中心衰患者的特征。
