Sharifi Hassan, Rezaei Mohammad Ali, Heydari Khayat Nastaran, Mohammadinia Neda
Department of Medical Surgical Nursing, School of Nursing, Iranshahr University of Medical Sciences, Iranshahr, Iran.
Department of Medical Surgical Nursing, School of Nursing, Bam University of Medical Sciences, Bam, Iran.
Int J Community Based Nurs Midwifery. 2018 Jan;6(1):89-98.
To decrease the readmission rate of heart failure (HF) patients, patients and their caregivers (CGs) should participate in symptoms assessment. This study aimed to assess the agreement between HF patients and their CGs on symptoms assessment.
Using a correlational design, 100 HF patients with their CGs (100 dyads) were recruited from Department of Cardiology, Iranshahr, during August-December 2014. Data were collected using modified Heart Failure Symptom Survey (HFSS).Pearson and intra-class correlation coefficients (ICC) were used to analyze the degree of agreement within HF dyads, using SPSS16. The level of significance was set at 0.05.
The most frequent and severe symptom assessed equally by partners was shortness of breath (SOB). Dyads had a good agreement on assessment of extremity swelling (r=0.87, P≤0.01, ICC=0.861 CI: 0.798-0.901), SOB at rest (r=0.83, P≤0.01, ICC=0.775, CI: 0.680-0.845), SOB with activity (r=0.81, P≤0.01, ICC=0.795 CI: 0.711-0.858), and feeling depressed (r=0.77, P≤0.01, ICC=0.769, CI: 0.675-0.838). 28.6% of HF dyad had a good, 50% had a moderate, and 21.4 % had a poor agreement in assessment of HF symptoms.
Most of the HF dyad members did not agree with each other on the assessment of symptoms. Knowledge, skills and ability of each dyad in HF symptoms assessment should be included in the patients' discharge planning and nurses must modify their misunderstanding or inability.
为降低心力衰竭（HF）患者的再入院率，患者及其护理人员应参与症状评估。本研究旨在评估HF患者及其护理人员在症状评估方面的一致性。
采用相关性设计，于2014年8月至12月从伊朗沙赫尔心脏病科招募了100名HF患者及其护理人员（100对）。使用改良的心力衰竭症状调查（HFSS）收集数据。采用Pearson和组内相关系数（ICC），使用SPSS16分析HF组内的一致程度。显著性水平设定为0.05。
伴侣双方评估最为频繁且严重程度相当的症状是呼吸急促（SOB）。在评估下肢肿胀（r = 0.87，P≤0.01，ICC = 0.861，CI：0.798 - 0.901）、静息时呼吸急促（r = 0.83，P≤0.01，ICC = 0.775，CI：0.680 - 0.845）、活动时呼吸急促（r = 0.81，P≤0.01，ICC = 0.795，CI：0.711 - 0.858）和感到抑郁（r = 0.77，P≤0.01，ICC = 0.769，CI：0.675 - 0.838）方面，双方具有良好的一致性。28.6%的HF组在HF症状评估方面一致性良好，50%的一致性中等，21.4%的一致性较差。
大多数HF组成员在症状评估上意见不一致。HF症状评估中每组的知识、技能和能力应纳入患者出院计划，护士必须纠正他们的误解或能力不足。
