College of Nursing and Health Sciences, University of Massachusetts Dartmouth, 285 Old Westport Road, North Dartmouth, MA 02747, USA.
College of Nursing and Health Sciences, University of Massachusetts Dartmouth, 285 Old Westport Road, North Dartmouth, MA 02747, USA.
Appl Nurs Res. 2020 Aug;54:151312. doi: 10.1016/j.apnr.2020.151312. Epub 2020 May 20.
To explore differences in self-care maintenance, management and confidence levels between American heart failure (HF) patients with and without executive dysfunction.
Evidence indicates some aspect of cognitive impairment is prevalent in up to 75% of the HF patient population. Moreover, cognitive impairment has been identified as a barrier to adequate self-care contributing to poor outcomes. There is limited understanding of the role executive function, a domain of cognitive performance, has on self-care behaviors for patients with HF.
This secondary analysis examined the role of executive function, measured by the Clock Drawing Test (CDT), in relation to self-care measures. The Self Care of Heart Failure Index v6.2 (SCHFI v6.2) was used to measure self-care maintenance, management, and confidence.
Participants had a mean age of 75.1 ± 12.5 years, identified as male (59.4%), with New York Heart Association (NYHA) class III (57.3%). Executive function impairment was present in 28% of the sample. Comparison of self-care maintenance and management scores between the two groups were not significant. However, participants with executive dysfunction demonstrated an average self-care confidence score of 48.6 ± 23.3, while participants with no executive function impairment demonstrated a higher average self-care confidence score of 61.5 ± 18.4. Differences in self-care confidence scores between the groups were statistically significant (p = .014).
HF self-care confidence is considered a moderator of self-care behaviors. Understanding the influence executive function has on self-care confidence may lead to a better understanding of those needing greater support with self-care behaviors.
探讨有无执行功能障碍的美国心力衰竭（HF）患者在自我护理维持、管理和信心水平方面的差异。
有证据表明，高达 75%的 HF 患者存在认知障碍的某个方面。此外，认知障碍已被确定为妨碍充分自我护理的一个因素，导致不良结局。对于执行功能（认知表现的一个领域）对 HF 患者自我护理行为的作用，了解有限。
这项二次分析研究了执行功能（通过画钟测验（CDT）测量）与自我护理措施的关系。使用心力衰竭自我护理量表 v6.2（SCHFI v6.2）来衡量自我护理维持、管理和信心。
参与者的平均年龄为 75.1±12.5 岁，男性占 59.4%，纽约心脏协会（NYHA）心功能分级为 III 级（57.3%）。28%的样本存在执行功能障碍。两组间自我护理维持和管理评分的比较没有显著差异。然而，执行功能障碍组的自我护理信心平均得分为 48.6±23.3，而无执行功能损害组的自我护理信心平均得分为 61.5±18.4。两组间自我护理信心评分差异有统计学意义（p=0.014）。
HF 自我护理信心被认为是自我护理行为的调节剂。了解执行功能对自我护理信心的影响可能有助于更好地了解那些需要更多自我护理行为支持的人。
