A Correlational Study of Illness Knowledge, Self-Care Behaviors, and Quality of Life in Elderly Patients With Heart Failure
A Correlational Study of Illness Knowledge, Self-Care Behaviors, and Quality of Life in Elderly Patients With Heart Failure
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DOI：
10.1097/jnr.0000000000000024
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发表时间：
2014-06-01
影响因子：
2.7
通讯作者：
Wang, Kai-Wei Katherine
中科院分区：
文献类型：
--
作者：
Liu, Min-Hui;Wang, Chao-Hung;Wang, Kai-Wei Katherine
背景：心力衰竭患者会经历影响生活质量的不良身体症状。近年来，台湾心力衰竭患者的数量一直在增长。目的：探讨老年心力衰竭患者疾病知识、自我护理行为与生活质量的相关性。方法：采用三份问卷的横断面研究设计。本研究于2008年1 - 6月在台湾某教学医院门诊部进行。65岁或以上的潜在参与者由医生根据心衰的几种诊断结果（包括国际疾病分类代码4280或4289）选择。卧床不起或预后少于6个月的患者被排除在外。结果：共纳入心力衰竭患者141例。大多数参与者是男性（51.8%），老年人（71岁以上49.6%），受过小学教育或文盲（69.5%），纽约心脏协会II级（61.0%）。参与者的平均左心室射血分数为41.1%。被试对疾病的认知较差（正确率为29.3%），且大多不了解自我护理的重要性。疾病知识与自我护理行为（r = - 0.42, p < 0.01）和生活质量（r = - 0.22, p < 0.01）均相关。疾病知识和年龄是自我护理行为的显著相关因素（R-2 = 0.22）；功能等级、独立生活和年龄是影响生活质量的显著相关因素（R-2 = 0.41）。结论/实践意义：本研究自我报告的自我照顾行为和生活质量较高的被试年龄更年轻，对疾病有更好的了解。此外，日常生活中的身体功能和独立性显著影响生活质量。对心力衰竭患者的护理，特别是老年人，应重点教授这些患者有关心力衰竭疾病和症状管理的知识。帮助老年心力衰竭患者促进和维持身体功能以独立处理日常生活活动是提高患者生活质量的关键。
Background: Patients with heart failure experience adverse physical symptoms that affect quality of life. The number of patients with heart failure in Taiwan has been growing in recent years.Purpose: This article examines correlations among illness knowledge, self-care behaviors, and quality of life in elderly patients with heart failure.Methods: A cross-sectional research design using three questionnaires was adopted. The study was undertaken in an outpatient department of a teaching hospital in Taiwan from January to June 2008. Potential participants aged 65 years or older were selected by a physician based on several diagnostic findings of heart failure that included an International Classification of Diseases' code 4280 or 4289. Patients who were bedridden or had a prognosis of less than 6 months were excluded from consideration.Results: One hundred forty-one patients with heart failure were recruited. Most participants were men (51.8%), older adults (49.6% older than 71 years old), and either educated to an elementary school level or illiterate (69.5%) and have New York Heart Association class II (61.0%). Participants had an average left ventricular ejection fraction of 41.1%. The illness knowledge of participants was poor (accuracy rate: 29.3%), and most were unaware of the significance of self-care. Illness knowledge correlated with both self-care behaviors (r = -.42, p < .01) and quality of life (r = -.22, p < .01). Illness knowledge and age were identified as significant correlated factors of self-care behaviors (R-2 = .22); and functional class, living independently, and age were identified as significant correlated factors of quality of life (R-2 = .41).Conclusions/Implications for Practice: Participants in this study with higher self-reported self-care behaviors and quality of life were younger in age and had better illness knowledge. Furthermore, physical function and independence in daily living significantly affected quality of life. Care for patients with heart failure, particularly older adults, should focus on teaching these patients about heart failure illness and symptom management. Assisting elderly patients with heart failure to promote and maintain physical functions to handle activities of daily living independently is critical to improving patient quality of life.