Ding Wen, Lu Jingyu, Wang Fei, Bai Ling, Liu Juan, Wang Ru
General Hospital of Ningxia Medical University, 804 Shengli Street, Xingqing District, Yinchuan, China.
Ningxia Medical University, Yinchuan, China.
BMC Geriatr. 2025 Apr 29;25(1):294. doi: 10.1186/s12877-025-05959-w.
Good self-management behaviors can improve the physical function and quality of life of patients with heart failure and reduce hospitalization, mortality, and medical expenses. While the overall self-management level among patients with chronic heart failure (CHF) in China is low, previous studies have often used a cross-sectional design, and few have followed up on patients' self-management beyond 6 months after discharge. This study aimed to explore the factors influencing and the changes in the self-management level of patients with CHF and provide a basis for the timing and choice of interventions within 1 year after discharge.
A longitudinal study was conducted from December 2021 to June 2022, including patients with CHF who met all the inclusion criteria. Data on demographics, disease-related details, social support, self-efficacy, and other information were collected during hospitalization (T0) and reevaluated at 1 month (T1), 3 months (T2), 6 months (T3), and 12 months (T4) after discharge.
A total of 213 patients were enrolled at T0, with 206, 201, 189, and 173 patients completing follow-up at T1, T2, T3, and T4, respectively. The self-management score was lowest at T0, highest at T1, began to decline at T2, and stabilized at T3; however, T3 remained higher than T0. Social support, self-efficacy, disease course, medication type, education level, and personal monthly income were identified as factors influencing self-management.
The study findings indicate that self-management is a dynamic process of change. The level of self-management was at a high level 3 months after the patients were discharged from the hospital, but showed a decreasing trend from 6 months, which was related to numerous factors. This study helps to provide a theoretical basis for the timing and content of self-management intervention for patients with CHF by clinical healthcare professionals.
良好的自我管理行为可改善心力衰竭患者的身体功能和生活质量，降低住院率、死亡率和医疗费用。虽然我国慢性心力衰竭（CHF）患者的整体自我管理水平较低，但以往研究多采用横断面设计，很少对患者出院6个月后的自我管理情况进行随访。本研究旨在探讨CHF患者自我管理水平的影响因素及变化情况，为出院后1年内干预措施的时机和选择提供依据。
于2021年12月至2022年6月进行一项纵向研究，纳入所有符合纳入标准的CHF患者。在患者住院期间（T0）收集人口统计学、疾病相关细节、社会支持、自我效能感等信息，并在出院后1个月（T1）、3个月（T2）、6个月（T3）和12个月（T4）进行重新评估。
T0共纳入213例患者，T1、T2、T3和T4分别有206例、201例、189例和173例患者完成随访。自我管理得分在T0时最低，T1时最高，T2时开始下降，T3时趋于稳定；不过，T3仍高于T0。社会支持、自我效能感、病程、用药类型、教育程度和个人月收入被确定为影响自我管理的因素。
研究结果表明，自我管理是一个动态变化的过程。患者出院后3个月自我管理水平处于较高水平，但6个月后呈下降趋势，这与多种因素有关。本研究有助于为临床医护人员对CHF患者进行自我管理干预的时机和内容提供理论依据。
