Cognitive impairment and self-care in heart failure.
Cognitive impairment and self-care in heart failure.
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DOI：
10.2147/clep.s44560
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发表时间：
2013
影响因子：
3.9
通讯作者：
Saczynski JS
中科院分区：
文献类型：
--
作者：
Hajduk AM;Lemon SC;McManus DD;Lessard DM;Gurwitz JH;Spencer FA;Goldberg RJ;Saczynski JS
心力衰竭(HF)是一种在老年人中普遍存在的慢性疾病，需要广泛的自我护理以防止失代偿和住院。认知障碍可能会影响进行HF自理活动的能力。我们研究了急性心力衰竭住院患者的认知障碍和坚持自我护理之间的关系。前瞻性队列研究。共有577名患者(平均年龄=71岁，44%为女性)因心力衰竭在美国和加拿大的五个医疗中心住院。参与者接受了访问，以了解有关使用欧洲心力衰竭自我护理行为量表自我报告遵守自我护理的信息。我们使用标准化测量方法在三个领域(记忆、处理速度和执行功能)评估认知障碍。通过查阅病历获得患者的人口学和临床特征。多变量线性回归被用来检验认知障碍和调整人口统计学和临床因素的自我护理实践之间的关联。共有453名患者(79%)在至少一个认知领域受损。有整体认知障碍的患者对自我护理活动的平均依从性与没有认知障碍的患者没有显著差异(30.5对29.6；45分量表)。然而，在多变量模型中，记忆受损与较低的自理得分相关(P=0.006)。认知障碍在因心力衰竭住院的老年患者中非常普遍。记忆力受损与对自我护理实践的坚持较差有关。对心力衰竭患者进行记忆障碍筛查可能有助于识别自理能力差的患者，这些患者可能受益于定制的疾病管理计划。
Heart failure (HF) is a prevalent chronic disease in older adults that requires extensive self-care to prevent decompensation and hospitalization. Cognitive impairment may impact the ability to perform HF self-care activities. We examined the association between cognitive impairment and adherence to self-care in patients hospitalized for acute HF. Prospective cohort study. A total of 577 patients (mean age = 71 years, 44% female) hospitalized for HF at five medical centers in the United States and Canada. Participants were interviewed for information on self-reported adherence to self-care using the European Heart Failure Self-care Behaviour Scale. We assessed cognitive impairment in three domains (memory, processing speed, and executive function) using standardized measures. Patients’ demographic and clinical characteristics were obtained through medical record review. Multivariable linear regression was used to examine the association between cognitive impairment and self-care practices adjusting for demographic and clinical factors. A total of 453 patients (79%) were impaired in at least one cognitive domain. Average adherence to self-care activities among patients with global cognitive impairment did not differ significantly from those without cognitive impairment (30.5 versus 29.6; 45-point scale). However, impaired memory was associated with lower self-care scores (P = 0.006) in multivariable models. Cognitive impairment is highly prevalent among older patients hospitalized for HF. Memory impairment is associated with poorer adherence to self-care practices. Screening for memory impairment in patients with HF may help to identify patients at risk for poor self-care who may benefit from tailored disease management programs.