Wei Shuangshuang, Zhou Yu, Shu Pan, Jiang Xiaolian
West China School of Nursing/West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, Sichuan 610041, China.
West China School of Nursing, Department of Cardiology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, Sichuan 610041, China.
Eur J Cardiovasc Nurs. 2025 Mar 3;24(2):231-239. doi: 10.1093/eurjcn/zvae145.
Patient activation (PA) is crucial for effective self-management of people with heart failure (HF). Clarifying factors associated with PA might be important to develop interventions to promote PA. This study aimed to explore context factors associated with PA in people with HF.
Two hundred and sixty-eight patients were enrolled in a cross-sectional study (median age = 65 years). We surveyed variables based on context factors of the individual and family self-management theory, including demographic and disease factors, quality of chronic care, family function, and depression. Correlation analysis was conducted for data analysis, and path analysis was used to verify our hypothesis model about context factors and PA. The median PA score was 51.10. Path analysis showed that age, educational level, living arrangement, device therapy, quality of chronic care, family function, and depression were directly or indirectly related to PA. The quality of chronic care mediated the associations between device therapy and educational level and PA. Age, educational level, living arrangement, and quality of chronic care affected family function and then affected activation. Depression mediated the relationships between the quality of chronic care, educational level, family function, and PA.
This study increased the understanding of factors associated with PA in the HF population. When assessing PA in people with HF, those who are older, have a low educational level, and living alone need more attention from healthcare professionals. Interventions focusing on improving the quality of chronic care, family function, and depression might help activate people to practice self-management.
患者激活（PA）对于心力衰竭（HF）患者的有效自我管理至关重要。明确与PA相关的因素对于制定促进PA的干预措施可能很重要。本研究旨在探讨HF患者中与PA相关的背景因素。
268名患者纳入一项横断面研究（中位年龄 = 65岁）。我们基于个体和家庭自我管理理论的背景因素调查了变量，包括人口统计学和疾病因素、慢性护理质量、家庭功能和抑郁情况。采用相关性分析进行数据分析，并使用路径分析来验证我们关于背景因素与PA的假设模型。PA得分中位数为51.10。路径分析表明，年龄、教育水平、生活安排、器械治疗、慢性护理质量、家庭功能和抑郁与PA直接或间接相关。慢性护理质量介导了器械治疗、教育水平与PA之间的关联。年龄、教育水平、生活安排和慢性护理质量影响家庭功能，进而影响激活情况。抑郁介导了慢性护理质量、教育水平、家庭功能与PA之间的关系。
本研究增进了对HF人群中与PA相关因素的理解。在评估HF患者的PA时，年龄较大、教育水平低且独居的患者需要医疗保健专业人员给予更多关注。专注于改善慢性护理质量、家庭功能和抑郁情况的干预措施可能有助于促使患者进行自我管理。
