Waldréus Nana, Chung Misook L, van der Wal Martje Hl, Jaarsma Tiny
Department of Neurobiology, Division of Nursing, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden,
College of Nursing, University of Kentucky, Lexington, KY, USA.
Patient Prefer Adherence. 2018 Oct 24;12:2223-2231. doi: 10.2147/PPA.S167724. eCollection 2018.
Patients with heart failure (HF) can suffer from increased thirst intensity and distress. Trajectories of thirst intensity and distress from hospital to home are unclear. The aim of this study was to describe thirst intensity and distress trajectories in patients from the time of hospital admission to 4 weeks after discharge, and describe trajectories of thirst intensity and distress by patients' characteristics (gender, age, body mass index [BMI], plasma urea, anxiety, and depression).
In this observational study, data were collected from patients with HF (n=30) at hospital admission, discharge, and at 2 and 4 weeks after discharge. Thirst intensity (visual analog scale, 100 mm) and distress (Thirst Distress Scale-HF, score 9-45) were used. Trajectories were examined using growth modeling.
Trajectory of the thirst intensity was significantly different, for patients with low and high thirst intensity levels (median cut-off 39 mm), from admission to 4 weeks follow up (thirst increased and decreased, respectively). Patients with high level of thirst distress (median score >22) at admission, having fluid restriction and women continued to have higher thirst distress over time. Patients feeling depressed had higher thirst intensity over time. There were no differences in the trajectories of thirst intensity and distress by age, BMI, plasma urea, and anxiety.
Intensity and distress of thirst, having fluid restriction, and feeling depressed at the admission were critical in predicting the trajectory of thirst intensity and distress after discharge to home in patients with HF. Effective intervention relieving thirst should be provided before their discharge to home.
心力衰竭（HF）患者可能会出现口渴强度增加和不适感。从医院到家中口渴强度和不适感的变化轨迹尚不清楚。本研究的目的是描述患者从入院到出院后4周的口渴强度和不适感变化轨迹，并按患者特征（性别、年龄、体重指数[BMI]、血浆尿素、焦虑和抑郁）描述口渴强度和不适感变化轨迹。
在这项观察性研究中，收集了30例HF患者在入院时、出院时以及出院后2周和4周的数据。使用口渴强度（视觉模拟量表，100mm）和不适感（心力衰竭口渴不适量表，评分9 - 45）。使用生长模型检查变化轨迹。
对于口渴强度低和高的患者（中位数临界值39mm），从入院到4周随访期间，口渴强度变化轨迹显著不同（分别是口渴增加和减少）。入院时口渴不适感水平高（中位数评分>22）、有液体限制的患者以及女性随着时间推移口渴不适感持续较高。感到抑郁的患者随着时间推移口渴强度更高。按年龄、BMI、血浆尿素和焦虑划分，口渴强度和不适感变化轨迹没有差异。
入院时的口渴强度和不适感、有液体限制以及感到抑郁对于预测HF患者出院回家后口渴强度和不适感变化轨迹至关重要。应在患者出院回家前提供有效的缓解口渴干预措施。
