Teng Hsiu-Chin, Yeh Mei-Ling, Wang Mei-Hua
1 Department of Nursing, Cheng Hsin General Hospital, ROC.
2 Graduate Institute of Integration of Traditional Chinese Medicine with Western Nursing, National Taipei University of Nursing and Health Sciences, ROC.
Eur J Cardiovasc Nurs. 2018 Dec;17(8):717-727. doi: 10.1177/1474515118778453. Epub 2018 May 18.
Patients with heart failure experience not only impaired physical condition, but also their physical activity, moods, and quality of life may be diminished.
The purpose of this study was to investigate the effects of 12-week walking with breathing program on physical activity tolerance considering time-dependent physiological factors and time-independent interoceptive awareness, as well as psychosocial factors.
This randomized controlled trial recruited 90 heart failure patients and randomly assigned them. The walking with breathing group received the walking and breathing intervention for 12 weeks but the control group did not. Outcomes included activity tolerance measured by 6-minute walk distance, moods assessed by the Hospital Anxiety and Depression Scale, quality of life determined by the EuroQol 5-Dimensions, oxygen saturation by pulse oximetry, and interoceptive awareness by the Multidimensional Assessment of Interoceptive Awareness scale. Data were collected before the intervention at baseline and at Weeks 2, 4 and 12.
The results of the generalized estimating equation showed the 6-minute walk distance in the walking with breathing group was significantly different across time ( p<0.001) compared with the control group at baseline. Oxygen saturation by pulse oximetry ( p=0.04) and Trusting on the Multidimensional Assessment of Interoceptive Awareness scale ( p=0.001) significantly and positively correlated with results of the 6-minute walk distance. There were significant between-group differences at Week 12 in anxiety ( p=0.03) and quality of life ( p=0.02) but not depression ( p=0.06).
Walking with breathing improved heart failure patients' tolerance of physical activity, probably because of improved oxygen saturation and trusting interoceptive awareness. Walking with breathing also improved patients' anxiety and quality of life.
心力衰竭患者不仅身体状况受损，其身体活动、情绪和生活质量也可能下降。
本研究旨在探讨为期12周的呼吸步行计划对身体活动耐量的影响，同时考虑时间依赖性生理因素、非时间依赖性内感受性觉知以及社会心理因素。
这项随机对照试验招募了90名心力衰竭患者并将他们随机分组。呼吸步行组接受为期12周的步行与呼吸干预，而对照组则未接受该干预。结局指标包括通过6分钟步行距离测量的活动耐量、通过医院焦虑抑郁量表评估的情绪、通过欧洲五维健康量表测定的生活质量、通过脉搏血氧饱和度仪测量的血氧饱和度以及通过内感受性觉知多维评估量表评估的内感受性觉知。在干预前的基线以及第2、4和12周收集数据。
广义估计方程的结果显示，与基线时的对照组相比，呼吸步行组的6分钟步行距离随时间有显著差异（p<0.001）。脉搏血氧饱和度（p=0.04）以及内感受性觉知多维评估量表中的信任维度（p=0.001）与6分钟步行距离的结果显著正相关。在第12周时，两组在焦虑（p=0.03）和生活质量（p=0.02）方面存在显著组间差异，但在抑郁方面无显著差异（p=0.06）。
呼吸步行改善了心力衰竭患者的身体活动耐量，可能是由于血氧饱和度提高和对内感受性觉知的信任增强。呼吸步行还改善了患者的焦虑和生活质量。
