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坦桑尼亚达累斯萨拉姆心脏医院的一项定性研究:护士对向心力衰竭患者提供自我护理管理教育的看法。

Nurses' perspectives on the provision of self-care management education to patients with heart failure: A qualitative study at Cardiac Hospital, Dar es Salaam Tanzania.

机构信息

Department of Nursing Services, Muhimbili National Hospital-Mloganzila, Dar es Salaam, Tanzania.

Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

出版信息

PLoS One. 2024 Jul 12;19(7):e0306459. doi: 10.1371/journal.pone.0306459. eCollection 2024.


DOI:10.1371/journal.pone.0306459
PMID:38995909
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11244802/
Abstract

BACKGROUND: Patients' education along with a motivation for developing self-care management skills is an essential component in the management of heart failure(HF). Self-care management education has been practiced by nurses in many hospitals. However, there is inadequate evidence for the provision of self-care management education in low-income countries including Tanzania. Lack of self-care management education to patients with HF during discharge is the most common reason for re-admission to hospitals. AIM: This study aimed to explore nurses' perspectives focusing on facilitators and barriers to the provision of self-care management education to patients with heart failure at Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania. MATERIALS AND METHODS: This study used a qualitative descriptive design. Purposive sampling was used to recruit 12 study participants. In-depth interviews were used to collect the data. We used thematic analysis to come up with the themes and sub-themes. RESULTS: The two major themes emerged from this study; The first theme is "Improved patient quality of life and health outcome" which describes factors that motivate nurses to continue giving self-care management education to heart failure patients. The second theme is "Reduced effective uptake of self-care management education" which describes nurses'perspectives on barriers for providing self-care management education to heart falure patients. Nurses highlight some barriers while providing self-care management education to patients with heart failure including;inadequate knowledge of self-care management among nurses, lack of privacy during the provision of self-care education, poor communication skills among nurses, and lack of learning materials. Also, nurses pointed out facilitators that influence the provision of self-care management education such as increased involvement of family members and the use of peer educators. CONCLUSIONS AND RECOMMENDATIONS: Poor self-care management for patients with heart failure results in readmission and prolonged hospital stay. Family involvement and the use of peer educators are the key steps in the improvement of self-care management for patients with HF. However, patient cognitive impairment and poverty which contribute to poor health outcomes, should be taken into consideration when planning for discharge for patients with HF. Self-care management education should be part of routine health care.

摘要

背景:患者教育以及培养自我护理管理技能的动机是心力衰竭(HF)管理的重要组成部分。许多医院的护士都在进行自我护理管理教育。然而,在包括坦桑尼亚在内的低收入国家,提供自我护理管理教育的证据不足。HF 患者出院时缺乏自我护理管理教育是他们再次入院的最常见原因。

目的:本研究旨在探讨坦桑尼亚达累斯萨拉姆贾卡亚·基奎特心脏研究所的护士对提供 HF 患者自我护理管理教育的看法,重点关注促进和阻碍这一教育的因素。

材料与方法:本研究采用定性描述设计。采用目的性抽样方法招募了 12 名研究参与者。采用深入访谈收集数据。我们使用主题分析得出主题和子主题。

结果:本研究产生了两个主要主题;第一个主题是“提高患者生活质量和健康结果”,描述了激励护士继续为 HF 患者提供自我护理管理教育的因素。第二个主题是“自我护理管理教育的有效实施减少”,描述了护士对提供 HF 患者自我护理管理教育的看法障碍。护士在为 HF 患者提供自我护理管理教育时强调了一些障碍,包括护士自我护理管理知识不足、提供自我护理教育时缺乏隐私、护士沟通技巧差以及缺乏学习材料。此外,护士还指出了影响自我护理管理教育实施的促进因素,例如增加家庭成员的参与和使用同伴教育者。

结论和建议:HF 患者自我护理管理不善会导致再次入院和住院时间延长。家庭成员的参与和使用同伴教育者是改善 HF 患者自我护理管理的关键步骤。然而,在为 HF 患者制定出院计划时,应考虑患者认知障碍和贫困等导致不良健康结果的因素。自我护理管理教育应成为常规医疗保健的一部分。

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引用本文的文献

[1]
Experiences of care home staff in the delivery of heart failure care: a grounded theory.

BMC Geriatr. 2025-7-2

[2]
Real-Life Experiences of Self-Capacity Management in Patients with Chronic Heart Failure: A Qualitative Study.

Patient Prefer Adherence. 2025-6-17

[3]
Mediating effect of illness perception between self-care ability and health-promoting behaviors among patients with stable coronary artery disease.

PLoS One. 2025-2-21

本文引用的文献

[1]
Cognitive Impairment in Heart Failure-A Review.

Biology (Basel). 2022-1-23

[2]
Improve self-care in heart failure.

Int J Nurs Sci. 2021-1-21

[3]
Patients' Experiences of a Nurse-Led, Home-Based Heart Failure Self-management Program: Findings From a Qualitative Process Evaluation.

J Med Internet Res. 2021-4-27

[4]
Self-care of heart failure patients: practical management recommendations from the Heart Failure Association of the European Society of Cardiology.

Eur J Heart Fail. 2021-1

[5]
Heart failure disease management: a systematic review of effectiveness in heart failure with preserved ejection fraction.

ESC Heart Fail. 2020-2

[6]
Heart failure: preventing disease and death worldwide.

ESC Heart Fail. 2014-9

[7]
Effects of a family support program on self-care behaviors in patients with congestive heart failure.

Iran J Nurs Midwifery Res. 2013-3

[8]
Role of self-care in the patient with heart failure.

Curr Cardiol Rep. 2012-6

[9]
Sociocultural influences on heart failure self-care among an ethnic minority black population.

J Cardiovasc Nurs. 2013

[10]
Women with heart failure are at high psychosocial risk: a systematic review of how sex and gender influence heart failure self-care.

Cardiol Res Pract. 2011-3-6

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