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心力衰竭患者的年轻群体的体验。

The Experiences of Younger Individuals Living With Heart Failure.

机构信息

Alison Walsh, PhD, RN, OCN, CNE Nurse Educator/NCLEX Specialist, Assessment Technologies Institute (ATI). Lisa Kitko, PhD, RN, FAHA, FAAN Associate Professor, College of Nursing, The Pennsylvania State University, University Park. Judith Hupcey, EdD, FAAN Associate Dean for Graduate Education, College of Nursing, The Pennsylvania State University, University Park.

出版信息

J Cardiovasc Nurs. 2018 Nov/Dec;33(6):E9-E16. doi: 10.1097/JCN.0000000000000525.

Abstract

BACKGROUND

Heart failure (HF) impacts 1.7 million Americans between the ages of 20 and 59 years, but limited research exists addressing the issues unique to this age group.

OBJECTIVE

The aim of this study was to investigate the experiences of younger persons living with HF.

METHODS

Semistructured interviews (n = 18) were analyzed using a qualitative thematic analysis.

RESULTS

Six themes emerged: (1) role fulfillment: participants who perceived their roles as a parent, caregiver, spouse, employee, and friend have been negatively affected by HF; (2) autonomy: participants frequently linked their well-being to a sense of independence, productivity, and purpose; (3) financial impact: most of the sample expressed financial instability further complicated by existing disability policies; (4) perception of self: recurrent statements revealed participants feeling judged because of their HF diagnosis and younger age; (5) retrospective life changes: participants reflected on past decisions and often blamed themselves for their current health; and (6) symptom burden: participants reported higher levels of psychosocial symptoms, such as depression, anxiety, and fatigue.

CONCLUSIONS

Younger individuals living with HF reported overwhelmingly poor health-related quality of life that was linked to the 6 themes identified previously. The effect of HF was seen on numerous life events that traditionally occur earlier in the life course such as establishing a career, meaningful relationships, family, and financial security. This directly impacted health-related quality of life by disrupting what each individual perceived as important to them, which took a toll on their overall mental health. To provide holistic care to younger patients living with HF, interventions that address the heavy burden of psychosocial symptoms and policy changes associated with financial burden and disability laws must be developed.

摘要

背景

心力衰竭(HF)影响了 170 万 20 至 59 岁的美国人,但针对该年龄段特有问题的研究有限。

目的

本研究旨在探讨年轻 HF 患者的经历。

方法

对 18 名参与者的半结构化访谈进行了分析,采用定性主题分析。

结果

出现了 6 个主题:(1)角色履行:参与者认为自己作为父母、照顾者、配偶、员工和朋友的角色受到 HF 的负面影响;(2)自主性:参与者经常将自己的幸福感与独立、生产力和目标感联系起来;(3)财务影响:大多数参与者表示经济不稳定,再加上现有的残疾政策,使情况更加复杂;(4)自我认知:反复出现的陈述表明,参与者因 HF 诊断和年轻而感到被评判;(5)生活变化的回顾:参与者反思过去的决定,经常为自己目前的健康状况自责;(6)症状负担:参与者报告了更高水平的心理社会症状,如抑郁、焦虑和疲劳。

结论

年轻 HF 患者报告的健康相关生活质量极差,与之前确定的 6 个主题有关。HF 的影响体现在许多传统上发生在生命早期的生活事件上,例如建立事业、建立有意义的关系、家庭和经济保障。这直接影响到健康相关的生活质量,因为它扰乱了每个人认为对自己重要的事情,从而对他们的整体心理健康造成了影响。为了为年轻 HF 患者提供全面的护理,必须制定干预措施来解决心理社会症状的沉重负担以及与经济负担和残疾法律相关的政策变化。

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