Patterns of heart failure symptoms are associated with self-care behaviors over 6 months.
Patterns of heart failure symptoms are associated with self-care behaviors over 6 months.
复制标题
心力衰竭症状的模式与 6 个月以上的自我护理行为相关。
DOI：
10.1177/1474515118759074
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发表时间：
2018-08
影响因子：
2.9
通讯作者：
Lee CS
中科院分区：
文献类型：
--
作者：
Auld JP;Mudd JO;Gelow JM;Lyons KS;Hiatt SO;Lee CS
心力衰竭 (HF) 症状和自我护理都与患者的预后相关。尽管人们认为症状会促进自我护理，但随着时间的推移，支持这一假设的证据有限。确定随着时间的推移，身体症状模式是否与心力衰竭自我护理显着相关。潜在混合分析用于根据呼吸困难、嗜睡和水肿等身体症状来识别亚组（使用 HF 躯体感知和 Epworth 嗜睡量表）。使用生长模型来确定症状亚组是否与 6 个月内的自我护理行为（使用心力衰竭自我护理指数）相关。使用逻辑回归确定了预测亚组成员资格可能性的社会人口统计学和临床变量。样本 (n=146) 平均年龄 57 岁，70% 为男性，59% 患有 III/IV 级心力衰竭。确定了两个症状亚组（熵=0.91）；高症状组（n = 24（16％））随着时间的推移症状没有显着变化（高持续），低症状组（n = 122（84％））随着时间的推移症状没有显着变化（低持续）。高持续组在基线和超过 6 个月内与更好的自我护理行为显着相关。女性（OR=3.67，p=0.023）和抑郁症状较多的患者（OR=1.16，p=0.015）更有可能属于高持续症状组。接受肾素-血管紧张素-醛固酮系统药物治疗的患者属于高症状组的可能性较小（OR=0.17，p=0.015）。随着时间的推移，受症状困扰的患者始终会更加积极地进行自我护理行为。这项研究的结果支持症状是自我护理行为的重要驱动因素。
Both heart failure (HF) symptoms and self-care are associated with patient outcomes. Although it is thought that symptoms drive self-care, there is limited evidence to support this assumption over time. Determine whether patterns of physical symptoms are significantly associated with HF self-care over time. Latent mixture analysis was used to identify sub-groups based on physical symptoms of dyspnea, sleepiness and edema (using the HF Somatic Perception and Epworth Sleepiness Scales). Growth modeling was used to determine if symptom sub-groups were associated with self-care behaviors (using the Self-care in HF Index) over 6 months. Socio-demographic and clinical variables predicting likelihood of sub-group membership were identified using logistic regression. The sample (n=146) was on average 57 years old, 70% were men and 59% had class III/IV HF. Two symptom sub-groups were identified (entropy=0.91); a high symptom group (n=24(16%)) with no significant change in symptoms over time (high sustained), and low symptom group (n=122(84%)) with no significant change in symptoms over time (low sustained). The high sustained group was associated significantly with better self-care behaviors at baseline and over 6 months. Women (OR=3.67, p=0.023) and patients with more depressive symptoms (OR=1.16, p=0.015) were more likely to be in the high sustained symptom group. Those treated with a renin-angiotensin-aldosterone system agent were less likely to be in the high symptom group (OR=0.17, p=0.015). Patients bothered more by symptoms are consistently more engaged in self-care behaviors over time. Results of this study support symptoms as an important driver of self-care behaviors.
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