Department of Health Sciences, University of Opole, 68 Katowicka Street, 45-060 Opole, Poland.
Medical and Diagnostic Centre (MDC), 9 Niklowa Street, 08-110 Siedlce, Poland.
Int J Environ Res Public Health. 2022 Apr 24;19(9):5170. doi: 10.3390/ijerph19095170.
The aim of this cross-sectional study was to analyze the variables that influence the effectiveness of home care in patients with chronic cardiovascular disease and their informal caregivers. The study was conducted in 193 patients and their 161 informal caregivers. The study used the WHOQOL-BREF Quality of Life Questionnaire, the health behavior inventory questionnaire (HBI), the Camberwell assessment of need short appraisal schedule (CANSAS) and the hospital anxiety and depression scale-modified (HADS-M) version. Spearman's rank correlation coefficient test and logistic regression were used for analyses. Analysis of patients revealed an association between home care effectiveness and the following variables (OR per unit): age (OR = 0.98, 95% CI: 0.95-0.99), educational level (OR = 1.45, 95% CI: 1.05-2.02), financial status (OR = 0.43, 95% CI: 0.21-0.83), medication irregularity (OR = 0.25, 95% CI: 0.07-0.72), presence of comorbidities (OR = 6.18, 95% CI: 1.83-23.78), health care services provided by a nurse (OR = 1.25, 95% CI: 1.03-1.64), and number of visits to a cardiology clinic (OR = 1.25, 95% CI: 1.02-1.59). There was no association between care effectiveness and sex ( = 0.28), place of residence ( = 0.757), duration of cardiovascular disease ( = 0.718), number of home visits ( = 0.154), nursing interventions ( = 0.16), and adherence to lifestyle change recommendations ( = 0.539) or proper dietary habits ( = 0.355). A greater chance of improved health care effectiveness was found in patients whose caregivers reported higher social (OR = 1.24, 95% CI: 1.09-1.44), psychological (OR = 1.68, 95% CI: 1.25-2.37), and physical (OR = 1.24, 95% CI: 1.05-1.49) quality of life. Patients with cardiovascular disease who were characterized by lower educational attainment, poorer financial status, fewer visits to cardiology clinics, lower utilization of medical services, poorer self-perception of mental and physical well-being, recent onset of disease symptoms, and irregular use of medications, were much more likely to have poorer health care effectiveness. Patients with cardiovascular disease and their caregivers can be well supported at home as long as the care model is tailored to the specific needs. This includes family care coordination in the health care team, home care, and general practice support.
本横断面研究旨在分析影响慢性心血管疾病患者及其非专业照护者家庭护理效果的变量。研究纳入了 193 名患者及其 161 名非专业照护者。研究采用 WHOQOL-BREF 生活质量问卷、健康行为量表问卷（HBI）、Camberwell 需求评估短评估量表（CANSAS）和改良医院焦虑和抑郁量表（HADS-M）版本。采用 Spearman 秩相关系数检验和逻辑回归进行分析。对患者的分析表明，家庭护理效果与以下变量存在关联（单位 OR）：年龄（OR=0.98，95%CI：0.95-0.99）、教育程度（OR=1.45，95%CI：1.05-2.02）、财务状况（OR=0.43，95%CI：0.21-0.83）、用药不规则（OR=0.25，95%CI：0.07-0.72）、合并症（OR=6.18，95%CI：1.83-23.78）、护士提供的医疗保健服务（OR=1.25，95%CI：1.03-1.64）和心内科就诊次数（OR=1.25，95%CI：1.02-1.59）。家庭护理效果与性别（ = 0.28）、居住地（ = 0.757）、心血管疾病持续时间（ = 0.718）、家访次数（ = 0.154）、护理干预（ = 0.16）和生活方式改变建议（ = 0.539）或适当饮食习惯（ = 0.355）的依从性无关。研究发现，患者的照顾者报告较高的社会（OR=1.24，95%CI：1.09-1.44）、心理（OR=1.68，95%CI：1.25-2.37）和身体（OR=1.24，95%CI：1.05-1.49）生活质量，家庭护理效果改善的可能性更大。具有以下特征的心血管疾病患者，其家庭护理效果较差：教育程度较低、经济状况较差、就诊心内科次数较少、医疗服务利用率较低、自我感知身心健康状况较差、疾病症状近期出现以及用药不规则。为了提高家庭护理的效果，心血管疾病患者和他们的照护者需要接受个性化的支持。这包括在医疗团队中进行家庭护理协调、家庭护理和全科医疗支持。
