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应激性生活事件与心力衰竭:一项分析患者观点的混合方法研究。

Stressful Life Events and Heart Failure: A Mixed-Method Study to Analyze the Patient's Perspective.

作者信息

Di Giacomo Dina, Cilli Eleonora, Guerra Federica, Barbati Francesco, Petroni Renata, Sciarra Luigi, Romano Silvio

机构信息

Life, Health and Environmental Sciences Department, University of L'Aquila, P.le Tommasi 1, L'Aquila, Italy.

Heart Failure Clinic, ASL 1 Abruzzo, L'Aquila, Italy.

出版信息

Cardiol Ther. 2025 Jun;14(2):199-217. doi: 10.1007/s40119-025-00406-8. Epub 2025 Apr 17.

Abstract

INTRODUCTION

The challenge in heart failure medical practice is to address the clinical and laboratory method integrations for the shared decision-making process in caring for patients and families. Furthermore, stressful life events may worsen outcomes in patients with heart failure. This study aimed to explore patient perceptions regarding cardiac care analyzing the individual needs and features of adverse life event experiences.

METHODS

A mixed-methods design was used in this study. This quantitative research focuses on clinical (medical and psychological) data. Giorgi's phenomenological method was applied to the interview analysis.

RESULTS

Qualitative analyses highlighted the role of patient-engagement strategies powered by cardiologists in a personalized approach that favors adherence to complex medical therapies. Active patient involvement and associated engagement based on cardiologists' confidence are focal points for facilitating management-therapy strategies to improve outcomes and reduce the perception of the frailty burden. The quality of therapeutic relationships with cardiologists is a key protective factor for accurate risk stratification and therapeutic decision-making in patients, addressing the potential benefits of therapeutic interventions.

CONCLUSIONS

In conclusion, the engaged patient contributes to more efficient cardiological care and the personalized patient-centered approach leads to the more efficient 'cure and care' clinical model. In adverse life events, acute psychological and physiological stress responses intensify detrimental outcomes for patients with cardiovascular disorders. Integrative management of physical risks and mental resilience factors in the development of cardiac disease appears to be strategic for patients with a positive quality of life (QoL) and clinical management of heart failure (HF).

摘要

引言

心力衰竭医疗实践中的挑战在于解决临床和实验室方法的整合问题,以便在照顾患者及其家属的过程中进行共同决策。此外,压力性生活事件可能会使心力衰竭患者的预后恶化。本研究旨在通过分析不良生活事件经历的个体需求和特征,探索患者对心脏护理的看法。

方法

本研究采用混合方法设计。这项定量研究侧重于临床(医学和心理学)数据。采用 Giorgi 的现象学方法进行访谈分析。

结果

定性分析强调了心脏病专家推动的患者参与策略在个性化方法中的作用,这种方法有利于患者坚持复杂的药物治疗。患者的积极参与以及基于心脏病专家信心的相关参与,是促进管理治疗策略以改善预后和减轻虚弱负担感的重点。与心脏病专家的治疗关系质量是患者进行准确风险分层和治疗决策的关键保护因素,体现了治疗干预的潜在益处。

结论

总之,积极参与的患者有助于提高心脏病护理效率,以患者为中心的个性化方法可形成更高效的“治疗与护理”临床模式。在不良生活事件中,急性心理和生理应激反应会加剧心血管疾病患者的有害后果。在心脏病发展过程中对身体风险和心理恢复力因素进行综合管理,对于提高生活质量(QoL)和心力衰竭(HF)临床管理的患者而言似乎具有战略意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f032/12084194/5132530f93f2/40119_2025_406_Fig1_HTML.jpg

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