Zhu Haixiang, Han Xiaoxue, Chen Jinxuan, Ding Jiaen, Wang Ruiting, Wu Yuan
Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.
Patient Prefer Adherence. 2025 Sep 9;19:2797-2806. doi: 10.2147/PPA.S529356. eCollection 2025.
This study aimed to investigate the relationship between self-management task performance and key heart failure biomarkers (NT-proBNP and uric acid) in elderly patients with chronic heart failure (CHF), and to explore the mediating role of disease severity in this relationship.
A total of 103 elderly CHF patients were recruited. And cross-sectional study conducted at two tertiary hospitals. Self-management task performance was assessed using a validated six-task evaluation scale. Clinical data, including NT-proBNP, uric acid, and other laboratory markers, were collected. Participants were stratified into low and high task performance groups based on the median score. Data were analyzed using partial correlation analysis, logistic regression, and restricted cubic spline analysis.
Patients with higher task performance were significantly younger (p < 0.001). Task performance was negatively correlated with NT-proBNP (r = -0.337, p < 0.001) and uric acid (r = -0.279, p = 0.005), indicating that lower performance was associated with higher biomarker levels, reflecting more severe disease progression. A non-linear decreasing trend in both NT-proBNP and uric acid levels was observed as task performance increased. Among the self-management tasks, medication-related tasks had the lowest success rates, while tasks related to oedema and dietary management showed higher performance rates.
Lower self-management task performance is significantly associated with elevated NT-proBNP and uric acid levels in elderly CHF patients, suggesting that poorer performance may indicate more advanced disease progression. These findings highlight the importance of targeted interventions to enhance self-management skills, particularly in medication adherence and disease monitoring, to improve patient outcomes. Future research should investigate the long-term clinical impact of improving task performance in CHF patients.
本研究旨在探讨老年慢性心力衰竭(CHF)患者自我管理任务表现与关键心力衰竭生物标志物(NT - 脑钠肽前体和尿酸)之间的关系,并探讨疾病严重程度在这种关系中的中介作用。
设计、患者与方法:共招募了103例老年CHF患者。在两家三级医院进行横断面研究。使用经过验证的六项任务评估量表评估自我管理任务表现。收集临床数据,包括NT - 脑钠肽前体、尿酸和其他实验室指标。根据中位数得分将参与者分为低任务表现组和高任务表现组。使用偏相关分析、逻辑回归和受限立方样条分析对数据进行分析。
任务表现较高的患者明显更年轻(p < 0.001)。任务表现与NT - 脑钠肽前体(r = -0.337,p < 0.001)和尿酸(r = -0.279,p = 0.005)呈负相关,表明表现较低与生物标志物水平较高相关,反映疾病进展更严重。随着任务表现的提高,NT - 脑钠肽前体和尿酸水平均呈现非线性下降趋势。在自我管理任务中,与药物相关的任务成功率最低,而与水肿和饮食管理相关的任务表现率较高。
老年CHF患者自我管理任务表现较低与NT - 脑钠肽前体和尿酸水平升高显著相关,提示表现较差可能表明疾病进展更严重。这些发现凸显了针对性干预以提高自我管理技能的重要性,特别是在药物依从性和疾病监测方面,以改善患者预后。未来研究应调查改善CHF患者任务表现的长期临床影响。