改善慢性心力衰竭患者的营养状况：基于跨理论模型的逐步营养管理计划的有效性。

Improving Nutritional Status in Chronic Heart Failure Patients: Effectiveness of a Transtheoretical Model-Based Stepwise Nutritional Management Program.

作者信息

Yuan Dejing, Xue Yuan, Zhou Yuefei

机构信息

Department of Nursing, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2025 May 20;18:1683-1695. doi: 10.2147/RMHP.S509402. eCollection 2025.

DOI:10.2147/RMHP.S509402

PMID:40416832

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12103193/

Abstract

OBJECTIVE

To explore the nutritional status of chronic heart failure (CHF) patients and evaluate the effect of a transtheoretical model-based stepwise nutritional management program on nutritional improvement.

METHODS

This study conducted a retrospective analysis of 100 chronic heart failure (CHF) patients admitted to our hospital from March 2023 to May 2024. After applying inclusion and exclusion criteria, the patients were divided into an observation group and a control group. The observation group received a stepwise nutritional management program based on the transtheoretical model (TTM), while the control group received routine care. Nutritional improvement and clinical effects were compared between the two groups.

RESULTS

Among the 100 CHF patients, 27% had good nutritional status, 42% were at nutritional risk, and 31% had malnutrition. No significant differences in baseline data were found between the two groups (P > 0.05). After the intervention, the observation group showed significantly lower B-type natriuretic peptide (BNP) levels and higher left ventricular ejection fraction (LVEF) levels compared to the control group (P < 0.05). Psychological scores (Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS)) in the observation group were also significantly lower than those in the control group (P < 0.05). Additionally, serum total cholesterol (TC) and triglycerides (TG) levels were lower in the observation group (P < 0.05), and levels of prealbumin, transferrin, hemoglobin, and albumin were higher (P < 0.05). The Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores in the observation group were significantly lower than in the control group (P < 0.05).

CONCLUSION

The nutritional status of CHF patients is generally poor, and the transtheoretical model-based stepwise nutritional management program can effectively improve their nutritional status, enhance cardiac function, improve quality of life, and alleviate psychological burden. This intervention is promising for clinical practice.

摘要

目的

探讨慢性心力衰竭（CHF）患者的营养状况，并评估基于跨理论模型的逐步营养管理方案对营养改善的效果。

方法

本研究对2023年3月至2024年5月我院收治的100例慢性心力衰竭（CHF）患者进行回顾性分析。应用纳入和排除标准后，将患者分为观察组和对照组。观察组接受基于跨理论模型（TTM）的逐步营养管理方案，而对照组接受常规护理。比较两组的营养改善情况和临床效果。

结果

100例CHF患者中，27%营养状况良好，42%存在营养风险，31%存在营养不良。两组基线数据无显著差异（P>0.05）。干预后，观察组B型利钠肽（BNP）水平显著低于对照组，左心室射血分数（LVEF）水平显著高于对照组（P<0.05）。观察组的心理评分（自评抑郁量表（SDS）和自评焦虑量表（SAS））也显著低于对照组（P<0.05）。此外，观察组血清总胆固醇（TC）和甘油三酯（TG）水平较低（P<0.05），前白蛋白、转铁蛋白、血红蛋白和白蛋白水平较高（P<0.05）。观察组明尼苏达心力衰竭生活质量问卷（MLHFQ）评分显著低于对照组（P<0.05）。