心力衰竭症状的性别差异及与心力衰竭症状相关的因素。
Sex Differences in Heart Failure Symptoms and Factors Associated With Heart Failure Symptoms.
机构信息
Seongkum Heo, PhD, RN Associate Professor, College of Nursing, University of Arkansas for Medical Sciences, Little Rock. Mi-Seung Shin, PhD, MD Professor, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea. Seon Young Hwang, PhD, RN Professor, College of Nursing, Hanyang University, Seoul, South Korea. Minjeong An, PhD, RN Associate Professor, College of Nursing, Chonnam National University, Gwangju, South Korea. Jin-Kyu Park, PhD, MD Associate Professor, Department of Cardiology, Hanyang University Seoul Hospital, South Korea. SunHwa Kim, PhD, RN Nurse, Stroke Unit, Hanyang University Medical Center, Seoul, South Korea. Jae Lan Shim, PhD Department of Nursing, College of Medicine, Assistant Professor, Dongguk University, Gyeongju, South Korea. JinShil Kim, PhD, RN Professor, College of Nursing, Gachon University, Incheon, South Korea. The authors have no conflicts of interest to disclose.
出版信息
J Cardiovasc Nurs. 2019 Jul/Aug;34(4):306-312. doi: 10.1097/JCN.0000000000000579.
BACKGROUND
A majority of patients with heart failure (HF) experience HF symptoms. Some literature suggests sex differences in the status of and also factors associated with HF symptoms. However, information on common HF symptom status and factors associated with HF symptoms in male and female patients is scarce.
OBJECTIVES
The aim of this study was to examine HF symptom status and factors associated with HF symptoms in male and female patients with HF.
METHODS
Descriptive data on HF symptoms, psychological factors (depressive symptoms and perceived control), sociodemographic factors (age and sex), clinical factors (body mass index, comorbidities, medication, and left ventricular ejection fraction), and a behavioral factor (self-care) were collected in 70 male and 49 female patients with HF. Mann-Whitney U tests, χ tests, and stepwise regression models were used to address the objectives.
RESULTS
Fatigue was the most common HF symptom in both sexes, but male patients had less severe HF symptoms, including frequency, severity, and/or distress. In male patients, 2 psychological and 2 clinical factors (comorbidities and use of diuretics) were significantly associated with HF symptoms (adjusted R = 0.669, P < .001), whereas in female patients, only depressive symptoms were significantly associated with HF symptoms (adjusted R = 0.679, P < .001).
DISCUSSION
There were sex differences in HF symptoms and the factors associated with HF symptoms. Clinicians and researchers need to recognize and manage psychological factors in both sexes and clinical factors in male patients by using effective interventions to improve HF symptoms.
背景
大多数心力衰竭（HF）患者都经历过 HF 症状。一些文献表明，HF 症状的状况和相关因素存在性别差异。然而，关于男性和女性 HF 患者常见 HF 症状状况和相关因素的信息很少。
目的
本研究旨在检查男性和女性 HF 患者的 HF 症状状况和相关因素。
方法
收集了 70 名男性和 49 名女性 HF 患者的 HF 症状、心理因素（抑郁症状和感知控制）、社会人口因素（年龄和性别）、临床因素（体重指数、合并症、药物治疗和左心室射血分数）和行为因素（自我护理）的描述性数据。使用 Mann-Whitney U 检验、χ 检验和逐步回归模型来解决研究目的。
结果
疲劳是两性中最常见的 HF 症状，但男性患者的 HF 症状严重程度较低，包括频率、严重程度和/或痛苦程度。在男性患者中，2 个心理因素和 2 个临床因素（合并症和利尿剂的使用）与 HF 症状显著相关（调整后的 R = 0.669，P <.001），而在女性患者中，只有抑郁症状与 HF 症状显著相关（调整后的 R = 0.679，P <.001）。
讨论
HF 症状和相关因素存在性别差异。临床医生和研究人员需要通过使用有效的干预措施来改善 HF 症状，认识并管理两性的心理因素以及男性患者的临床因素。
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