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“我们只有彼此”:心力衰竭患者-照护者对疾病管理的混合方法分析。

"We're all we got is each other": Mixed-methods analysis of patient-caregiver dyads' management of heart failure.

机构信息

Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA.

Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA.

出版信息

Heart Lung. 2022 Sep-Oct;55:24-28. doi: 10.1016/j.hrtlng.2022.04.009. Epub 2022 Apr 15.

Abstract

BACKGROUND

Individuals living with heart failure often require informal caregiving assistance for optimal self-care maintenance. The influence of caregiver burden and resilience on dyadic congruence is not well understood.

OBJECTIVE

To compare how dyadic congruence is influenced by level of burden and resilience expressed by caregivers of patients with heart failure.

METHODS

Mixed-methods analysis of individuals with heart failure and their caregivers, focusing on measures of caregiver burden (Zarit Burden Interview) and resilience (Brief Resilience Scale). Data were integrated using the Heart Failure Care Dyadic Typology.

RESULTS

Twelve dyads (n=24 participants) were classified as Type II (n=7) and Type III (n=5) dyads. Among Type II dyads, average caregiver burden was 19.43 (± 13.89) and resilience was 3.16 (± 1.04). For Type III dyads, average caregiver burden was 3.80 (± 4.27) and resilience 4.07 (± 1.36), respectively. Two key themes were derived: 1) caregivers' tendency to take the lead, and 2) the usefulness of cognitive reframing. Data integration elucidated that theme 1 was more common among Type II dyads and those with higher burden, and theme 2 was more prevalent among Type III dyads and those with higher resilience.

CONCLUSION

Findings highlight important variances in how dyads collectively manage heart failure. Future inquiry should involve tailored intervention development to bolster informal caregivers' quality of life and ability to better support patients throughout their heart failure trajectory.

摘要

背景

心力衰竭患者通常需要非正规护理来进行最佳的自我护理。护理人员负担和适应力对双元一致性的影响尚未得到充分理解。

目的

比较心力衰竭患者的护理人员的负担和适应力水平如何影响双元一致性。

方法

采用心力衰竭患者及其护理人员的混合方法分析,重点关注护理人员负担(Zarit 负担访谈)和适应力(简短适应力量表)的测量。使用心力衰竭护理双元类型学整合数据。

结果

12 对(n=24 名参与者)被分类为 II 型(n=7)和 III 型(n=5)双元。在 II 型双元中,平均护理人员负担为 19.43(±13.89),适应力为 3.16(±1.04)。对于 III 型双元,平均护理人员负担为 3.80(±4.27),适应力为 4.07(±1.36)。得出了两个关键主题:1)护理人员倾向于带头,2)认知重构的有用性。数据整合阐明,主题 1 在 II 型双元和负担较高的双元中更为常见,而主题 2 在 III 型双元和适应力较高的双元中更为普遍。

结论

研究结果突出了双元共同管理心力衰竭的重要差异。未来的研究应涉及量身定制的干预措施的开发,以增强非正式护理人员的生活质量,并提高他们在心力衰竭患者治疗过程中更好地支持患者的能力。

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