心力衰竭患者的儿童自我状态与自我护理行为改变

Child ego state and self-care behavior change in heart failure patients.

作者信息

Yanagihara Kiyotaka, Kinugasa Yoshiharu, Kunimi Tetsuro, Kaneko Syuhei, Haruki Nobuhiko, Nakamura Kensuke, Kamitani Hiroko, Hirai Masayuki, Kato Masahiko, Yamamoto Kazuhiro

机构信息

Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Yonago, Japan.

出版信息

J Cardiol. 2021 Oct;78(4):294-300. doi: 10.1016/j.jjcc.2021.05.006. Epub 2021 Jun 2.

DOI:10.1016/j.jjcc.2021.05.006

PMID:34090754

Abstract

BACKGROUND

The psychological characteristics of ego functions interfere with self-care behavior in several diseases. However, the effect of ego functions on self-care behavior after education in heart failure (HF) remains unclear.

METHODS

Seventy-one HF patients were enrolled. Patients' scores on the Japanese version of the European Heart Failure Self-care Behaviour Scale (EHFScBS) were measured before and after the HF intervention, and the rate of change was used as an indicator of educational effectiveness. The Tokyo University Egogram New Ver. II was used to assess five types of ego state functions: Critical parent, Nurturing parent, Adult, Free Child, and Adapted Child (AC).

RESULTS

A comparison of the five ego states showed that AC scores were significantly lower than those of the other ego states (p < 0.01). Total EHFScBS scores significantly decreased from 33 (26-39) to 16 (14-20) (p < 0.01) after the HF education, and the median rates of change in EHFScBS was -46.2%. Patients with a lower rate of change in EHFScBS were more likely to have low AC scores, as characterized by a lack of compliance and coordination, and were less likely to receive higher education (all p < 0.05). Even after adjustment for covariates, low AC scores were independently associated with low rate of change in EHFScBS (p < 0.01).

CONCLUSIONS

Educational behavior change for self-care is less effective in HF patients with an ego state with low AC.

摘要

背景

自我功能的心理特征在多种疾病中会干扰自我护理行为。然而，自我功能对心力衰竭（HF）患者教育后自我护理行为的影响仍不清楚。

方法

纳入71例HF患者。在HF干预前后测量患者的日本版欧洲心力衰竭自我护理行为量表（EHFScBS）得分，并将变化率作为教育效果的指标。使用东京大学自我状态量表新版II评估五种类型的自我状态功能：批评性父母、养育性父母、成人、自由儿童和适应儿童（AC）。

结果

对五种自我状态的比较显示，AC得分显著低于其他自我状态（p<0.01）。HF教育后，EHFScBS总分从33（26 - 39）显著降至16（14 - 20）（p<0.01），EHFScBS的中位变化率为 - 46.2%。EHFScBS变化率较低的患者更有可能AC得分低，表现为缺乏依从性和协调性，且接受高等教育的可能性较小（所有p<0.05）。即使在对协变量进行调整后，低AC得分仍与EHFScBS的低变化率独立相关（p<0.01）。