A Web Application for Self-Monitoring Improves Symptoms in Chronic Systolic Heart Failure
A Web Application for Self-Monitoring Improves Symptoms in Chronic Systolic Heart Failure
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DOI：
10.1089/tmj.2014.0095
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发表时间：
2015-04-01
影响因子：
4.7
通讯作者：
Koelling, Todd M.
中科院分区：
文献类型：
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作者：
Dorsch, Michael P.;Farris, Karen B.;Koelling, Todd M.
目的：本研究的目的是确定通过自我监测促进慢性疾病进展的正念的Web应用程序是否改善了心力衰竭患者的生活质量。材料与方法：本研究为前瞻性单中心单组研究。参与者被告知如何使用Web应用程序，并在12周内每天进行自我监测。在基线和12周时进行全面的体格检查、纽约心脏协会（NYHA）分级评估、明尼苏达心力衰竭生活问卷（MLHFQ）和自我管理评估。结果：参与者包括年龄较大（平均59岁），主要为女性（63%），NYHA II级或III级症状。在12周的自我监测中，NYHA分级（介入前与介入后，2.5 +/- 0.13 vs 2.0 +/- 0.13; p=0.0032）和MLHFQ评分（分别为55.7 +/- 4.6 vs 42.6 +/- 5.1; p=0.0078）改善。体重也有改善的趋势（干预前与干预后，209 +/- 9.6磅与207 +/- 9.4磅;配对t检验，p=0.389），每周运动次数（分别为1.29 +/- 0.5和2.5 +/- 0.6; p=0.3）和步行距离（分别为572 +/- 147码和845 +/- 187码; p=0.119）。通过Web应用程序自我监测12周后，颈静脉扩张（干预前与干预后，8.1 +/- 0.6 cm与6.7 +/- 0.3 cm; p=0.083）和外周水肿（分别为29.2%与16.7%; p=0.375）减少。结论：12周以上自我监测心力衰竭的网络应用程序改善了NYHA分级和MLHFQ评分。身体活动和体格检查改善的趋势支持这些结果。报告钠限制饮食的患者数量在12周内增加，这可能导致了阳性结果。
Objective: The objective of this study was to determine if a Web application that promoted mindfulness of the progress of the chronic disease through self-monitoring improved quality of life in heart failure. Materials and Methods: This was a prospective single-center single-group study. Participants were instructed how to use the Web application and to perform self-monitoring daily for 12 weeks. A comprehensive physical exam, assessment of New York Heart Association (NYHA) class, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and an evaluation of self-management were performed in person at baseline and at 12 weeks. Results: Participants consisted of older (mean, 59 years), predominantly female (63%) adults with NYHA class II or III symptoms. NYHA classification (preintervention versus postintervention, 2.5 +/- 0.13 versus 2.0 +/- 0.13; p=0.0032) and MLHFQ score (55.7 +/- 4.6 versus 42.6 +/- 5.1, respectively; p=0.0078) improved over 12 weeks of self-monitoring. A trend toward improvement was also demonstrated in weight (preintervention versus postintervention, 209 +/- 9.6 pounds versus 207 +/- 9.4 pounds; by paired t test, p=0.389), number of times exercised per week (1.29 +/- 0.5 versus 2.5 +/- 0.6, respectively; p=0.3), and walk distance (572 +/- 147 yards versus 845 +/- 187 yards, respectively; p=0.119). Jugular venous distention (preintervention versus postintervention, 8.1 +/- 0.6 cm versus 6.7 +/- 0.3 cm; p=0.083) and peripheral edema (29.2% versus 16.7%, respectively; p=0.375) decreased after 12 weeks of self-monitoring via the Web application. Conclusions: A Web application for self-monitoring heart failure over 12 weeks improved both NYHA classification and MLHFQ score. The trend in improved physical activity and physical exam support these outcomes. The number of patients reporting a sodium-restricted diet increased over the 12 weeks, which may have led to the positive findings.