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慢性心力衰竭患者自我护理行为不良的发生率及预测因素。

Prevalence and predictors of poor self-care behaviors in patients with chronic heart failure.

机构信息

Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia.

出版信息

Sci Rep. 2024 Jan 23;14(1):1984. doi: 10.1038/s41598-024-52611-5.

Abstract

Despite the indispensable role of self-care behavior in managing heart failure, the practice of self-care behavior remains poor, especially in developing countries. There is a scarcity of research focusing on poor self-care behavior and its determinants within our specific context. Therefore, the objective of this study was to investigate the prevalence and predictors of poor self-care behavior among ambulatory heart failure patients. A facility-based cross-sectional study was conducted at a tertiary care hospital in Ethiopia, involving patients with heart failure. We utilized the European Heart Failure Self-Care Behavior Scale (EHFScBS-9) to evaluate adherence to self-care behaviors. Data were gathered through patient interviews and a review of medical records. A binary logistic regression analysis was performed to identify predictors of poor self-care behavior in heart failure patients. We included a total of 343 participants in the final analysis of this study. The findings revealed that a majority of the patients (73.8%) demonstrated poor overall self-care behavior. Specifically, the majority of patients did not engage in regular exercise (76.1%), failed to consult doctors in case of rapid weight gain (75.6%), did not monitor weight daily (71.5%), did not restrict fluid intake (69.9%), and did not contact doctors in case of experiencing fatigue (68.6%). Additionally, 32.4% of patients did not reach out to doctors when experiencing shortness of breath, 30% did not restrict salt intake, 29% did not adhere to prescribed medication, and only 7% did not consult doctors if edema occurred. Our findings indicated that rural residence (AOR: 5.76, 95% CI: 2.47-13.43), illiteracy (AOR: 2.64, 95% CI: 1.52-6.31), prior hospitalization (AOR: 2.09, 95% CI: 1.21-3.61), and taking five or more medications (AOR: 1.83, 1.01-3.33) were significant predictors of poor self-care behavior. In conclusion, a majority of the participants in our study demonstrated poor self-care behavior. Risk factors for this behavior included rural residence, illiteracy, prior hospitalization, and taking five or more medications. Therefore, it is crucial to prioritize these high-risk patients and implement interventional programs aimed at improving self-care behaviors and overall treatment outcomes in heart failure patients.

摘要

尽管自我护理行为在管理心力衰竭方面起着不可或缺的作用,但自我护理行为的实践仍然很差,尤其是在发展中国家。在我们特定的背景下,很少有研究关注自我护理行为不良及其决定因素。因此,本研究的目的是调查门诊心力衰竭患者不良自我护理行为的流行情况及其预测因素。这是在埃塞俄比亚一家三级保健医院进行的一项基于机构的横断面研究,涉及心力衰竭患者。我们使用欧洲心力衰竭自我护理行为量表(EHFScBS-9)评估对自我护理行为的依从性。数据通过患者访谈和病历回顾收集。采用二元逻辑回归分析确定心力衰竭患者不良自我护理行为的预测因素。我们总共纳入了 343 名患者进行最终分析。研究结果表明,大多数患者(73.8%)表现出不良的整体自我护理行为。具体来说,大多数患者没有进行规律运动(76.1%),没有在体重快速增加时咨询医生(75.6%),没有每天监测体重(71.5%),没有限制液体摄入(69.9%),没有在感到疲劳时联系医生(68.6%)。此外,32.4%的患者在出现呼吸困难时没有联系医生,30%的患者没有限制盐的摄入,29%的患者没有遵医嘱服药,只有 7%的患者在出现水肿时咨询医生。我们的研究结果表明,农村居住(AOR:5.76,95%CI:2.47-13.43)、文盲(AOR:2.64,95%CI:1.52-6.31)、既往住院(AOR:2.09,95%CI:1.21-3.61)和服用五种或更多药物(AOR:1.83,95%CI:1.01-3.33)是不良自我护理行为的显著预测因素。综上所述,我们研究中的大多数参与者表现出不良的自我护理行为。这种行为的危险因素包括农村居住、文盲、既往住院和服用五种或更多药物。因此,优先考虑这些高危患者并实施干预计划,以改善心力衰竭患者的自我护理行为和整体治疗结果至关重要。

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