The changes and factors associated with post-discharge self-care behaviors among Chinese patients with heart failure.
The changes and factors associated with post-discharge self-care behaviors among Chinese patients with heart failure.
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DOI：
10.2147/ppa.s88431
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发表时间：
2015
影响因子：
2.2
通讯作者：
Dolansky MA
中科院分区：
文献类型：
--
作者：
Hu X;Hu X;Su Y;Qu M;Dolansky MA
自我护理行为对于心力衰竭患者获得良好结局至关重要。随着时间的推移，了解与自我保健相关的因素对于提供适当和有针对性的干预措施非常重要。然而，对中国心力衰竭患者出院后自我护理行为的变化及影响因素知之甚少。探讨中华人民共和国心力衰竭患者出院后3个月内自我护理行为的变化及影响因素。本研究采用描述性设计和方便样本。从2013年6月至2014年6月招募了来自中华人民共和国成都市华西医院和昂津医院两家医院的患者（N=128）。研究工具包括：社会支持量表、医院焦虑抑郁量表、慢性病自我效能6项量表和欧洲心力衰竭自我护理行为量表。采用多元线性回归分析确定与基线、出院后1个月和3个月的自我护理行为相关的因素。患者的自我护理行为较差，且随时间的延长而明显下降（F=4.09，P<0.05）。基线时与自我护理行为相关的因素包括：教育水平、合并症和社会支持。影响出院后1个月及3个月自我照顾行为的因素包括：教育程度、合并症、社会支持及自我效能。在基线、出院后1个月和3个月，归因于这些因素的自我护理行为的差异分别为43%、46%和42%。应向教育水平低的心力衰竭患者和患有多种合并症的患者提供额外的支持。出院后的追踪、照护的持续性及家庭照顾者的整合，对于改善病患的自我照护行为及获得更好的结果是必要的。
Self-care behavior is essential for achieving good outcomes among patients with heart failure. Understanding the factors associated with self-care over time is important for the provision of appropriate and targeted interventions. However, little is known regarding the changes and factors associated with post-discharge self-care behaviors among Chinese patients with heart failure. To investigate the changes and factors of self-care behaviors during the first 3 months following discharge among patients with heart failure in the People’s Republic of China. A descriptive design with a convenience sample was utilized in this study. Patients (N=128) from two hospitals, West China Hospital and Angjin Hospital, in Chengdu, People’s Republic of China, were recruited from June 2013 to June 2014. The instruments used in the study included the following: the Social Support Rating Scale, the Hospital Anxiety and Depression Scale, the Self-Efficacy for Managing Chronic Disease 6-Item Scale, and the European Heart Failure Self-Care Behaviour Scale. Multivariate linear regression analyses were used to identify the factors related to self-care behaviors at baseline, 1 month, and 3 months following discharge. Patients’ self-care behaviors were poor and decreased significantly over time (F=4.09, P<0.05). The factors associated with self-care behaviors at baseline included the following: education level, comorbidities, and social support. The factors related to self-care behaviors at 1 and 3 months following discharge included the following: education level, comorbidities, social support, and self-efficacy. The variances in self-care behaviors attributed to these factors were 43%, 46%, and 42% at baseline, 1 month, and 3 months following discharge, respectively. Additional support should be provided to patients with heart failure with low educational levels and patients with multiple comorbidities. Follow-up, continuity of care, and family caregiver integration following discharge are necessary for the said patients to improve their self-care behaviors and obtain better outcomes.