Department of Nursing, Chung-Ang University, Seoul, South Korea.
J Clin Nurs. 2023 Sep;32(17-18):6427-6440. doi: 10.1111/jocn.16658. Epub 2023 Feb 23.
This study aimed to identify the associations between longitudinal trajectories of self-care behaviours and unplanned hospital readmissions in patients with heart failure.
Adherence to self-care behaviours is crucial to prevent hospital readmissions; however, self-care behaviours remain unsatisfactory among patients with heart failure. Studies of long-term trajectories of self-care behaviours and their influence on hospital readmissions are limited in this population.
A prospective, longitudinal observational study.
Among 137 participants with heart failure (mean age 67.36 years, 62% men), we analysed the 1-year follow-up data to determine the association between 1-year trajectories of self-care behaviours and hospital readmissions using Kaplan-Meier analysis and multivariable Cox regression, adjusted for confounding variables.
Self-care behaviour trajectories of heart failure patients were classified as 'high-stable' (58.4%) or 'low-sustained' (41.6%). The cumulative rate of readmissions for the low-sustained class was higher than that of the high-stable class for all periods. Factors influencing readmissions included anaemia, cognitive function, frailty and self-care behaviours trajectories. The low-sustained class had a 2.77 times higher risk of readmissions within 1 year than that in the high-stable class.
Longitudinal self-care behaviours pattern trajectories of heart failure patients were stratified as high-stable and low-sustained. Routine follow-up assessment of patients' self-care behavioural patterns, including anaemia and frailty, and cognitive function can minimise unplanned hospital readmissions.
Identification of trajectory patterns of self-care behaviours over time and provision of timely and individualised care can reduce readmissions for heart failure patients. Healthcare professionals should recognise the significance of developing tailored strategies incorporating longitudinal self-care behavioural patterns in heart failure patients.
The study has been reported in accordance with the STROBE checklist (Appendix S1).
Patients have completed a self-reported questionnaire after providing informed consent.
本研究旨在确定心力衰竭患者自我护理行为的纵向轨迹与非计划性住院再入院之间的关联。
遵守自我护理行为对于预防住院再入院至关重要；然而，心力衰竭患者的自我护理行为仍然不尽如人意。关于该人群自我护理行为的长期轨迹及其对住院再入院的影响的研究有限。
前瞻性、纵向观察性研究。
在 137 名心力衰竭患者（平均年龄 67.36 岁，62%为男性）中，我们分析了 1 年的随访数据，以使用 Kaplan-Meier 分析和多变量 Cox 回归来确定自我护理行为 1 年轨迹与住院再入院之间的关联，同时调整混杂变量。
心力衰竭患者的自我护理行为轨迹分为“高稳定”（58.4%）或“低持续”（41.6%）。低持续组在所有时期的再入院累积率均高于高稳定组。影响再入院的因素包括贫血、认知功能、虚弱和自我护理行为轨迹。低持续组在 1 年内再入院的风险是高稳定组的 2.77 倍。
心力衰竭患者的纵向自我护理行为模式轨迹分为高稳定和低持续。常规随访评估患者的自我护理行为模式，包括贫血和虚弱以及认知功能，可以最大限度地减少非计划性住院再入院。
识别心力衰竭患者自我护理行为随时间的轨迹模式，并提供及时和个体化的护理，可以减少心力衰竭患者的再入院。医疗保健专业人员应认识到制定针对心力衰竭患者的个体化策略的重要性，该策略包括纵向自我护理行为模式。
本研究已按照 STROBE 清单（附录 S1）进行报告。
患者在提供知情同意后完成了一份自我报告问卷。
