School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, 19104-4217 PA, USA.
School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, 19104-4217 PA, USA.
Heart Lung. 2019 May-Jun;48(3):179-185. doi: 10.1016/j.hrtlng.2018.12.008. Epub 2019 Jan 9.
Three behaviors advocated to minimize fluid-related hospitalizations in patients with heart failure (HF) are restricted sodium and fluid intake and consistent oral diuretic use. Adherence to behaviors intended to decrease risk of hospitalization is believed to vary over time, but surprisingly little research has addressed patterns of adherence in HF patients.
To describe patterns over time of 3 recommended self-care behaviors (i.e., diet, fluid intake, and diuretic dosing) in adults with HF and to determine how time and behavior influenced adherence rates.
We enrolled 24 adults hospitalized for a HF exacerbation and discharged on a loop diuretic into a descriptive, longitudinal pilot study. Over 3-months, diuretic use was measured using electronic event monitoring, and participants were telephoned regularly to assess sodium and fluid intake. Data were summarized for each 2-week intervals.
The overall adherence rates were 42.4% for low sodium diet, 96.4% for fluid restriction, and 84.7% for the diuretic regimen. Early after hospital discharge, medication adherence was the highest, and dietary adherence was the lowest, but adherence to diet and diuretic use decreased significantly over time.
Although participants were just discharged from the hospital after an acute exacerbation of HF, all three behavioral patterns decreased markedly over the 3-month follow-up period.
为了尽量减少心力衰竭（HF）患者的液体相关住院治疗，有三种行为受到推崇，即限制钠和液体摄入以及持续使用口服利尿剂。据信，为降低住院风险而采取的行为的依从性会随时间而变化，但令人惊讶的是，很少有研究关注 HF 患者的依从性模式。
描述 HF 成人患者中 3 种推荐的自我护理行为（即饮食、液体摄入和利尿剂剂量）随时间的变化模式，并确定时间和行为如何影响依从率。
我们招募了 24 名因 HF 加重而住院并接受袢利尿剂治疗出院的成年人，进行了一项描述性、纵向的试点研究。在 3 个月内，使用电子事件监测来测量利尿剂的使用情况，定期通过电话评估钠和液体摄入情况。在每 2 周的间隔内对数据进行总结。
低钠饮食的总体依从率为 42.4%，液体限制的依从率为 96.4%，利尿剂方案的依从率为 84.7%。出院后早期，药物依从性最高，饮食依从性最低，但饮食和利尿剂使用的依从性随时间显著下降。
尽管参与者在 HF 急性加重后刚刚出院，但在 3 个月的随访期间，所有三种行为模式都明显下降。
