Wang Angran, Zhang Ning, Li Mengtian, Mao Qin, Ma Anna, Wang Guodong, Li Meng, Li Qiong
School of Nursing, Xinxiang Medical University, Xinxiang, Henan, People's Republic of China.
Nursing Department, The Third People's Hospital of Henan Province, Zhengzhou, Henan, People's Republic of China.
Patient Prefer Adherence. 2025 Jun 17;19:1747-1762. doi: 10.2147/PPA.S519773. eCollection 2025.
Capacity overload is a persistent risk throughout the progression of heart failure. And effective capacity management can help patients control fluid retention and improve capacity overload, which is crucial for improving the prognosis of patients with chronic heart failure (CHF). However, current research often focuses on physiological and pathological mechanisms, with limited exploration of the psychological and social factors influencing patients' self-management behaviors. Additionally, while many studies have addressed the importance of capacity management, there are remains a gap in understanding how patients' experiences with capacity management strategies can be optimized to improve adherence and long-term outcomes.
This study aims to explore the personal experiences of CHF patients regarding self-capacity management, identify the barriers they face in implementing self-management behaviors, and examine factors contributing to non-adherence. The goal is to provide a foundation for future intervention strategies.
A qualitative descriptive design was employed, using semi-structured in-depth interviews with CHF patients. The transcribed data were coded and analyzed thematically based on Colaizzi's phenomenological data analysis method. NVivo 14 software was employed for the analysis.
The findings reveal that individuals with CHF encounter various barriers to effective self-capacity management. These barriers not only hinder their understanding and application of management strategies but also reduce their intrinsic motivation to adopt and sustain healthy behaviors. Four themes were identified: (1) Symptom distress leading to changes in daily behavior, (2) Barriers to implementing capacity management behaviors, (3) Low awareness of capacity management, and (4) Lack of knowledge regarding capacity management.
Healthcare providers must consider age-related differences and varying levels of knowledge receptivity among patients. Tailored educational programs that cater to individual patient needs are essential for enhancing accessibility and ensuring continuity of care. Regular post-education assessments, alongside continuous supervision and guidance, are crucial to improve patient understanding, promote behavioral changes, validate the effectiveness of educational interventions, and support the long-term adoption of self-management practices.
容量超负荷是心力衰竭进展过程中持续存在的风险。有效的容量管理有助于患者控制液体潴留并改善容量超负荷，这对于改善慢性心力衰竭（CHF）患者的预后至关重要。然而，目前的研究往往侧重于生理和病理机制，对影响患者自我管理行为的心理和社会因素探索有限。此外，虽然许多研究都强调了容量管理的重要性，但在理解如何优化患者容量管理策略的体验以提高依从性和长期结局方面仍存在差距。
本研究旨在探讨CHF患者自我容量管理的个人经历，确定他们在实施自我管理行为时面临的障碍，并研究导致不依从的因素。目标是为未来的干预策略提供基础。
采用定性描述性设计，对CHF患者进行半结构化深度访谈。根据Colaizzi的现象学数据分析方法对转录数据进行编码和主题分析。使用NVivo 14软件进行分析。
研究结果表明，CHF患者在有效的自我容量管理方面遇到各种障碍。这些障碍不仅阻碍了他们对管理策略的理解和应用，还降低了他们采用和维持健康行为的内在动力。确定了四个主题：（1）症状困扰导致日常行为改变，（2）实施容量管理行为的障碍，（3）容量管理意识低，（4）缺乏容量管理知识。
医疗保健提供者必须考虑患者之间与年龄相关的差异以及知识接受程度的不同。针对个体患者需求的定制教育计划对于提高可及性和确保护理的连续性至关重要。定期的教育后评估，以及持续的监督和指导，对于提高患者的理解、促进行为改变、验证教育干预的有效性以及支持长期采用自我管理实践至关重要。
