College of Nursing, Michigan State University, 1355 Bogue Street East Lansing, MI 48824, USA.
Department of Nursing, University of Bisha, Al Nakhil St, Bisha 61922, Saudi Arabia.
Eur J Cardiovasc Nurs. 2023 Apr 12;22(3):236-244. doi: 10.1093/eurjcn/zvac042.
To identify and provide clarity on factors that influence coping and the type of coping strategies used by patients with heart failure (HF) to improve health-related quality of life (HRQoL).
The Arksey and O'Malley template framed this scoping review guided by the stress and coping model. Five databases were explored: PubMed, Web of Science, Cochrane, CINAHL, and PsycINFO. Keywords included HF, quality of life, coping, and influencing factors. Eligibility criteria involved patients with HF, reported on coping strategies and HRQoL, and published in English. Thirty-five studies were included (4 randomized controlled trials, 27 cross-sectional, and 4 qualitative/mixed methods). Active emotional coping (e.g. acceptance) and problem-focused (e.g. seeking social support) coping strategies were linked to better HRQoL, while avoidant emotional coping (e.g. denial) was linked to worse HRQoL. In the presence of the stressor of HF severity, key factors that influenced the types of the coping strategy included sex, age, social support, income, education, spiritual beliefs, and illness duration. However, the evidence on the effectiveness of the type of coping on HRQoL remains inadequate due to the majority of studies being cross-sectional.
Problem-focused and active emotional coping strategies are associated with improved HRQoL. However, their effect is inconclusive due to the lack of experimental studies. Additional predictive studies will enhance the understanding of coping among HF patients.
确定并阐明影响心力衰竭（HF）患者应对方式的因素以及他们所使用的应对策略类型，以改善与健康相关的生活质量（HRQoL）。
本研究采用 Arksey 和 O'Malley 模板，以压力和应对模型为指导，对 5 个数据库（PubMed、Web of Science、Cochrane、CINAHL 和 PsycINFO）进行了探索：HF、生活质量、应对和影响因素。纳入标准为：HF 患者、报告应对策略和 HRQoL 的研究，以及发表于英文期刊的研究。共纳入 35 项研究（4 项随机对照试验、27 项横断面研究和 4 项定性/混合方法研究）。积极的情绪应对（如接受）和以问题为中心的应对策略（如寻求社会支持）与更好的 HRQoL 相关，而回避情绪应对（如否认）与更差的 HRQoL 相关。在 HF 严重程度这一压力源存在的情况下，影响应对策略类型的关键因素包括性别、年龄、社会支持、收入、教育、精神信仰和疾病持续时间。然而，由于大多数研究为横断面研究，因此关于应对类型对 HRQoL 的有效性的证据仍然不足。
以问题为中心和积极的情绪应对策略与 HRQoL 的改善相关。然而，由于缺乏实验研究，其效果尚无定论。更多的预测性研究将增进我们对 HF 患者应对方式的理解。
