Wehby D, Brenner P S
Department of Critical Care Services, Detroit Medical Center-Grace Hospital, MI 48235, USA.
Heart Lung. 1999 Jan-Feb;28(1):31-40. doi: 10.1016/s0147-9563(99)70041-5.
To determine the perceived learning needs of patients with heart failure (HF) compared with identified needs by registered nurses (RNs).
Descriptive, comparative.
Two midwestern hospitals: 1 community hospital and 1 that is part of a large, university-affiliated, integrated health care system.
A convenience sample of 84 adult patients with HF from left ventricular systolic dysfunction and 84 registered nurses.
The Heart Failure Learning Needs Inventory, developed for this study, was used to rate 98 individual items divided into 8 subscales suggested in the Agency for Health Care Policy and Research (AHCPR) practice guidelines. The subscales include general HF information, psychologic adaptation to illness, risk factors, medications, diet, activity, prognosis, and signs and symptoms.
Multivariate analysis of variance was completed. The patients perceived the subscales of general HF information, risk factors, medications, prognosis, and signs and symptoms as more important to learn than the RNs did (P <.05). Patients perceived diet information as less important to learn than the RNs did (P <. 05). There were no differences in the patients' and nurses' perceptions in the activity and psychologic subscales. The patients perceived all 8 subscales as more realistic to learn than the RNs did (P <.05). Although not in identical order, both groups ranked education related to medication and signs and symptoms as the 2 priority areas. Diet information was ranked eighth by the patients and third by the RNs.
The findings are consistent with previous research supporting the overall trend that patients with HF perceived patient education to be more important and realistic to learn during hospitalization than the nurses did. Patients and nurses identified education related to signs and symptoms and medication as the 2 most important content areas. In comparison with the AHCPR clinical practice guidelines, the group of RNs studied would ascribe the additional category of signs and symptoms as essential content to be taught during hospitalization.
确定心力衰竭（HF）患者所感知的学习需求，并与注册护士（RN）确定的需求进行比较。
描述性、比较性研究。
两家中西部医院：一家社区医院和一家隶属于大型大学附属综合医疗保健系统的医院。
从左心室收缩功能障碍患者中选取84名成年HF患者和84名注册护士组成的便利样本。
为本研究编制的心力衰竭学习需求量表用于对98个单项进行评分，这些单项分为医疗保健政策与研究机构（AHCPR）实践指南中建议的8个分量表。这些分量表包括一般HF信息、对疾病的心理适应、危险因素、药物、饮食、活动、预后以及体征和症状。
完成了多变量方差分析。患者认为一般HF信息、危险因素、药物、预后以及体征和症状这些分量表比注册护士认为的更重要（P<.05）。患者认为饮食信息的学习重要性低于注册护士（P<.05）。患者和护士在活动和心理分量表的认知上没有差异。患者认为所有8个分量表的学习内容比注册护士认为的更实际（P<.05）。尽管顺序不完全相同，但两组都将与药物和体征及症状相关的教育列为两个优先领域。饮食信息在患者中排名第八，在注册护士中排名第三。
研究结果与先前的研究一致，支持了总体趋势，即HF患者认为住院期间的患者教育比护士认为的更重要且更实际。患者和护士将与体征和症状以及药物相关的教育确定为两个最重要的内容领域。与AHCPR临床实践指南相比，所研究的注册护士群体将体征和症状这一额外类别视为住院期间必须教授的重要内容。
