Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA, United States of America.
J Pediatr Nurs. 2019 May-Jun;46:62-71. doi: 10.1016/j.pedn.2019.02.037. Epub 2019 Mar 8.
The purpose of this study is to examine the relationship among the three innate needs of Self-Determination Theory (SDT), self-management of care and adherence to treatment, and the relationship to health-related quality of life (HRQOL) for adolescents with congenital heart disease (CHD).
A non-experimental, cross-sectional, correlational design was conducted in a sample of 92 participants with CHD, ages 13 to 18 years. For data analysis, Pearson's correlations were used to explore associations between variables, and the hypotheses were tested using multiple linear regression.
Demographic and clinical data were collected: 15 ± 1.6 yrs; 59% male; 65% White; 43% mild CHD; 25% severe CHD. After controlling for covariates, regression analyses revealed relatedness (β = 0.64) and competence (β = 0.79) contributed significant variance to HRQOL, R = 0.56, p < .001; however, autonomy and self-management of care and treatment adherence did not contribute significant variance to HRQOL.
This study found that relatedness and competence were significantly associated with HRQOL in adolescents with CHD; however, autonomy and self-management of care and adherence to treatment were not. These findings demonstrate the importance of further examining relatedness and competence in adolescents with CHD.
Nursing care should focus on the improvement of social support systems and interventions to increase self-efficacy for adolescents with CHD.
本研究旨在探讨自我决定理论（SDT）的三种先天需求、自我护理管理与治疗依从性与先天性心脏病（CHD）青少年健康相关生活质量（HRQOL）之间的关系。
在一个由 92 名年龄在 13 至 18 岁的 CHD 参与者组成的非实验性、横断性、相关性设计的样本中进行了研究。为了进行数据分析，使用皮尔逊相关系数来探讨变量之间的关联，并用多元线性回归来检验假设。
收集了人口统计学和临床数据：15±1.6 岁；59%为男性；65%为白人；43%为轻度 CHD；25%为重度 CHD。在控制了协变量后，回归分析显示，关联性（β=0.64）和能力感（β=0.79）对 HRQOL 有显著贡献，R=0.56，p<0.001；然而，自主性、自我护理管理和治疗依从性对 HRQOL 没有显著的方差贡献。
本研究发现，关联性和能力感与 CHD 青少年的 HRQOL 显著相关；然而，自主性、自我护理管理和治疗依从性与 HRQOL 不相关。这些发现表明，进一步研究 CHD 青少年的关联性和能力感很重要。
护理应注重改善社会支持系统，并采取干预措施，以提高 CHD 青少年的自我效能感。
