Attaallah Sumayya, Klymko Kay, Hopp Faith Pratt
Wayne State University, Detroit, MI, USA.
Florida Health Care Plans, Holly Hill, FL, USA.
Gerontol Geriatr Med. 2016 Dec 21;2:2333721416684013. doi: 10.1177/2333721416684013. eCollection 2016 Jan-Dec.
It is estimated that 5.7 million Americans are living with heart failure (HF) today. Despite the fact that HF is one of the most common reasons people aged 65 years and older are admitted into the hospital, few studies describe the self-care in this older adult population. The purpose of the study was to review the current literature on self-care in this population to better understand the influence of selected factors on self-care and health outcomes. A literature search was completed and resulted in including 28 studies. Multiple factors have been reported as barriers to self-care including depression and presence of peripheral arterial disease. Factors having a positive effect on self-care are male gender, number of cardiologist referrals, and self-efficacy. There were few studies that described the association between cognitive functioning and self-care. There is a lack of strong evidence to support the association between self-care and health outcomes such as readmission rate, but recent studies suggest that a 30-day readmission is not a valid predictor of health outcomes. The assessment of the psychological factors and health care resource utilization patterns that may influence self-care is recommended. More research that addresses the role of cognitive factors in influencing self-care is needed.
据估计，目前有570万美国人患有心力衰竭（HF）。尽管心力衰竭是65岁及以上人群住院的最常见原因之一，但很少有研究描述这一年长成年人群体的自我护理情况。本研究的目的是回顾关于该人群自我护理的现有文献，以更好地了解选定因素对自我护理和健康结果的影响。完成了文献检索，最终纳入了28项研究。据报道，多种因素是自我护理的障碍，包括抑郁症和外周动脉疾病的存在。对自我护理有积极影响的因素包括男性、心脏病专家转诊次数和自我效能感。很少有研究描述认知功能与自我护理之间的关联。缺乏有力证据支持自我护理与再入院率等健康结果之间的关联，但最近的研究表明，30天再入院并不是健康结果的有效预测指标。建议评估可能影响自我护理的心理因素和医疗资源利用模式。需要更多研究来探讨认知因素在影响自我护理方面的作用。
