SYMptoms in chronic heart failure imPACT on burden of treatment (SYMPACT): a cross-sectional survey.
SYMptoms in chronic heart failure imPACT on burden of treatment (SYMPACT): a cross-sectional survey.
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这项研究旨在描述慢性心力衰竭(CHF)患者报告的症状和治疗负担(BOT)。BOT描述了疾病工作量、个人执行这项工作的能力以及由此对个人的影响。不堪重负的BOT与较差的生活质量和较差的临床结果有关。这项研究是英国第一次探索CHF患者的症状和BOT。这是一份针对CHF患者的横断面问卷调查。参与者完成了心力衰竭症状调查(HFSS；最高得分10)和明尼苏达州心力衰竭生活问卷(MLHFQ；最高得分：身体40分，情感25分，总分105分)，以衡量症状。使用患者的治疗和自我管理(PETS；最高得分100)问卷对BOT进行测量。采用描述性统计方法对参与者特征和问卷结果进行总结。症状和BOT之间的关系，通过工作量和影响指数进行总结，使用Spearman和Pearson的相关系数结合散点图来探索。这项调查共有333名参与者完成，他们的平均年龄为71岁(±13)岁。大多数人(89%)是从二级护理NHS信托基金招聘的，25%是女性。所有类型的心力衰竭都有代表。平均症状评分：HFSS负担评分2.4(±2.1)分，MLHFQ评分：躯体评分20(±12.4)分，情感评分9.9(±8.1)分，总分41.3(±26.3)分。PETS领域平均得分最高的是运动[51.3(±24.7)分]、饮食[40.3(±22.7)分]、医疗服务困难[39.9(±21.3)分]、身心疲劳[36.0(±25.7)分]。HFSS评分和MLHFQ身体和情绪分值与PETS工作量和影响指数之间存在成对相关关系。工作量指数与症状呈弱至中度正相关(0.326~0.487)，影响指数与症状呈中度至强正相关(0.553~0.725)。经Bonferroni‘s校正后，P值为0.006。CHF患者的症状与BOT有关。虽然症状负担较低，但CHF患者报告了较高水平的锻炼、饮食、保健互动等自我护理活动的负担，以及由于参与自我护理方案而造成的身心疲劳。观察到的较高水平的负担是在CHF的关键自我护理领域，并建议在哪些领域可以改善CHF患者的服务提供和支持，以减少BOT。临床医生可以通过关注麻烦的症状来个性化会诊，同时减轻疾病工作量，这可能会更好地使患者与充血性心力衰竭一起生活。
This study aimed to describe patient‐reported symptoms and burden of treatment (BoT) experienced by patients with chronic heart failure (CHF). BoT describes the illness workload, individual capacity to perform that work, and resultant impact on the individual. Overwhelming BoT is related to poor quality of life and worse clinical outcomes. This research is the first to explore symptoms and BoT in people with CHF, in the UK. This is a cross‐sectional questionnaire survey of CHF patients. Participants completed the Heart Failure Symptom Survey (HFSS; max score 10) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ; max scores: physical 40, emotional 25, and total 105), which measured symptoms. BoT was measured with the Patient Experience with Treatment and Self‐management (PETS; max score 100) questionnaires. Participant characteristics and questionnaire results were summarized using descriptive statistics. Relationships between symptoms and BoT, summarized by the workload and impact indices, were explored using Spearman's and Pearson's correlation coefficients together with scatter plots. The survey was completed by 333 participants, mean age of 71 (±13) years old. The majority (89%) were recruited from secondary care NHS trusts, and 25% were female. All types of heart failure were represented. Mean symptom scores were as follows: HFSS burden score: 2.4 (±2.1), and MLHFQ scores: physical score 20 (±12.4), emotional score 9.9 (±8.1), and total score 41.3 (±26.3). The highest mean PETS domain scores were exercise [51.3 (±24.7)], diet [40.3 (±22.7)], difficulty with healthcare services [39.9 (±21.3)], and physical and mental fatigue [36.0 (±25.7)]. Pairwise correlations were observed between HFSS scores and MLHFQ physical and emotional sub‐scores with PETS workload and impact indices. Positive correlations were weak to moderate (0.326–0.487) between workload index and symptoms, and moderate to strong between impact index and symptoms (0.553–0.725). The P value was 0.006, adjusted by Bonferroni's correction. Symptoms are associated with BoT in CHF patients. Although symptom burden was low, CHF patients reported higher levels of burden around self‐care activities of exercise, diet, healthcare interaction, as well as physical and mental fatigue due to engagement with self‐care regimens. Observed higher levels of burden were in key self‐care areas for CHF and suggest areas where service delivery and support of CHF patients may be improved to reduce BoT. Clinicians could individualize their consultations by focusing on troublesome symptoms, as well as alleviating illness workload, which may better enable patients to live well with CHF.
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影响因子：
4.6
作者：
Ivynian, S. E.;DiGiacomo, M.;Newton, P. J.
通讯作者：
Newton, P. J.
影响因子：
18.2
作者：
Jaarsma T;Hill L;Bayes-Genis A;La Rocca HB;Castiello T;Čelutkienė J;Marques-Sule E;Plymen CM;Piper SE;Riegel B;Rutten FH;Ben Gal T;Bauersachs J;Coats AJS;Chioncel O;Lopatin Y;Lund LH;Lainscak M;Moura B;Mullens W;Piepoli MF;Rosano G;Seferovic P;Strömberg A
通讯作者：
Strömberg A
影响因子：
2.9
作者：
May CR;Cummings A;Myall M;Harvey J;Pope C;Griffiths P;Roderick P;Arber M;Boehmer K;Mair FS;Richardson A
通讯作者：
Richardson A
影响因子：
18.2
作者：
Lainscak, Mitja;Blue, Lynda;Jaarsma, Tiny
通讯作者：
Jaarsma, Tiny
影响因子：
39.3
作者：
McMurray, John J. V.;Adamopoulos, Stamatis;Ponikowski, Piotr
通讯作者：
Ponikowski, Piotr