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日本慢性心力衰竭患者如何看待他们的疾病、自我护理及支持?

How do Japanese Patients with Chronic Heart Failure View Their Disease, Self-care, and Support?

作者信息

Nagata Shoko, Shiki Kosuke, Yagi Nobutaka, Sato Naoki

机构信息

Patient Engagement, Nippon Boehringer Ingelheim Co., Ltd., ThinkPark Tower 2-1-1 Osaki Shinagawa-ku, Tokyo, 141-6017, Japan.

Medicine Division, Nippon Boehringer Ingelheim Co., Ltd., Tokyo, Japan.

出版信息

Adv Ther. 2025 May 12. doi: 10.1007/s12325-025-03203-w.

Abstract

INTRODUCTION

Chronic heart failure (HF) is a progressive disease with increasing prevalence in Japan. Adherence to lifestyle modifications is important to prevent disease progression and to improve outcomes. An accumulation of insufficient self-care behaviors is an independent risk factor of hospitalization for HF and/or cardiac death; however, there is a lack of self-care awareness in patients with chronic HF. This study aims to increase the understanding of self-care behavior of people living with chronic HF in Japan.

METHODS

This non-interventional, cross-sectional study used an explanatory sequential design in mixed methods research with a quantitative and consecutive qualitative phase. In the quantitative research phase, an anonymous online survey questionnaire was distributed to 262 people and completed by 162 participants. In the qualitative phase, 15 participants who had completed the quantitative phase were selected using stratified random sampling from the survey participants and took part in a semi-structured interview. Endpoints included participant demographics and HF characteristics, physical and emotional burdens associated with HF, knowledge of disease, self-care, and treatment support in daily life.

RESULTS

In the quantitative study, 61.5% of participants were male, and 68.9% were ≥ 60 years old. In the qualitative study, 80.0% were male and 46.7% were ≥ 70 years old. Participants experienced physical and emotional burden due to their HF symptoms with > 60% finding brisk walking, and > 40% finding going up stairs to the second floor, burdensome or very burdensome, and approximately 70% experiencing some emotional burden. In general, participants trusted their physicians' instructions around self-care and had a high level of self-care adherence. Participants would like more information regarding HF treatment (68.0%), diet and nutrition (57.3%), and daily lifestyle tips to reduce HF burden (57.3%).

CONCLUSION

This study highlights the importance of patient education, and the need for multidisciplinary support for patients with chronic HF.

TRIAL REGISTRATION

UMIN000047055, March 1, 2022 and UMIN000049065, September 29, 2022.

摘要

引言

慢性心力衰竭(HF)是一种在日本患病率不断上升的进行性疾病。坚持生活方式的改变对于预防疾病进展和改善预后非常重要。自我护理行为不足的累积是因心力衰竭住院和/或心源性死亡的独立危险因素;然而,慢性心力衰竭患者缺乏自我护理意识。本研究旨在增进对日本慢性心力衰竭患者自我护理行为的理解。

方法

本非干预性横断面研究在混合方法研究中采用了解释性序列设计,包括定量和连续定性阶段。在定量研究阶段,向262人发放了匿名在线调查问卷,162名参与者完成了问卷。在定性阶段,从调查参与者中采用分层随机抽样方法选取15名完成定量阶段的参与者,参加半结构化访谈。研究终点包括参与者的人口统计学和心力衰竭特征、与心力衰竭相关的身体和情感负担、疾病知识、自我护理以及日常生活中的治疗支持。

结果

在定量研究中,61.5%的参与者为男性,68.9%的参与者年龄≥60岁。在定性研究中,80.0%为男性,46.7%的参与者年龄≥70岁。参与者因心力衰竭症状而承受身体和情感负担,超过60%的人认为快走有负担,超过40%的人认为上二楼有负担或负担很重,约70%的人有一定的情感负担。总体而言,参与者信任医生关于自我护理的指导,并且自我护理依从性较高。参与者希望获得更多关于心力衰竭治疗(68.0%)、饮食和营养(57.3%)以及减轻心力衰竭负担的日常生活小贴士(57.3%)的信息。

结论

本研究强调了患者教育的重要性,以及对慢性心力衰竭患者进行多学科支持的必要性。

试验注册

UMIN000047055,2022年3月1日;UMIN000049065,2022年9月29日。

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