照顾者对心力衰竭患者自我护理的贡献：一项定性描述性研究。
Caregiver Contribution to Self-care in Patients With Heart Failure: A Qualitative Descriptive Study.
机构信息
Angela Durante, MSN, RN PhD Student, Department of Biomedicine and Prevention University of Rome Tor Vergata, Italy. Marco Paturzo, PhD, RN Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy; Military Nurse (current), CELIO Military Hospital of Rome, Italy. Antonella Mottola, PhD, RN Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy; Nurse Manager (current), San Pio Hospital, Benevento, Italy. Rosaria Alvaro, MSN, RN, FESC Professor, Department of Biomedicine and Prevention University of Rome Tor Vergata, Italy. Victoria Vaughan Dickson, PhD, CRNP, FAHA, FAAN Associate Professor, New York University Rory Meyers College of Nursing. Ercole Vellone, PhD, RN, FESC Assistant Professor, Department of Biomedicine and Prevention University of Rome Tor Vergata, Italy.
出版信息
J Cardiovasc Nurs. 2019 Mar/Apr;34(2):E28-E35. doi: 10.1097/JCN.0000000000000560.
BACKGROUND
Caregiver contribution to heart failure (HF) self-care maintenance and management is important in HF care. Literature remains unclear regarding which practices caregivers perform to contribute to self-care for patients with HF, especially in Southern Europe.
OBJECTIVE
The objective of this study was to describe caregiver contributions to HF self-care maintenance (ie, treatment adherence and symptom monitoring) and management (ie, managing HF symptoms when they occur).
METHODS
Forty HF caregivers were enrolled from 3 outpatient clinics in Italy for a qualitative descriptive study. Data were collected with a semistructured interview and analyzed using content analysis.
RESULTS
Caregivers were 53.6 years old on average and mostly female (63.5%). Caregiver contributions to self-care maintenance included practices related to (1) monitoring medication adherence, (2) educating patients about HF symptom monitoring, (3) motivating patients to perform physical activity, and (4) reinforcing dietary restrictions. However, some of these practices were incorrect (eg, weighing the patient only once a week). Caregiver contributions to self-care management included practices related to (1) symptom recognition and (2) treatment implementation. Caregivers were able to recognize symptoms of HF exacerbation (eg, breathlessness) but lacked confidence regarding treatment implementation (eg, administering an extra diuretic).
CONCLUSIONS
Although caregivers described contributing to patients' HF self-care maintenance and management, some of their practices were incorrect. Because the caregiver contributions to HF self-care can improve patient outcomes, clinicians should routinely assess caregiver HF self-care practices and provide education and reinforcement regarding evidence-based practices.
背景
在心力衰竭（HF）的护理中，照顾者对患者自我护理的维持和管理的贡献非常重要。关于照顾者为 HF 患者的自我护理做出了哪些贡献，文献仍不清楚，尤其是在南欧。
目的
本研究的目的是描述照顾者对 HF 自我护理维持（即治疗依从性和症状监测）和管理（即管理 HF 症状发生时）的贡献。
方法
从意大利的 3 家门诊诊所招募了 40 名 HF 照顾者进行定性描述性研究。使用半结构式访谈收集数据，并使用内容分析进行分析。
结果
照顾者的平均年龄为 53.6 岁，大多数为女性（63.5%）。照顾者对自我护理维持的贡献包括与（1）监测药物依从性、（2）教育患者 HF 症状监测、（3）激励患者进行体育活动以及（4）强化饮食限制有关的实践。然而，其中一些做法是不正确的（例如，每周只给患者称重一次）。照顾者对自我护理管理的贡献包括与（1）症状识别和（2）治疗实施有关的实践。照顾者能够识别 HF 恶化的症状（例如，呼吸困难），但在治疗实施方面缺乏信心（例如，给予额外的利尿剂）。
结论
尽管照顾者描述了对患者 HF 自我护理的维持和管理做出了贡献，但他们的一些做法是不正确的。由于照顾者对 HF 自我护理的贡献可以改善患者的结局，因此临床医生应定期评估照顾者 HF 自我护理实践，并提供有关循证实践的教育和强化。
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