Self-care and quality of life in patients with advanced heart failure: The effect of a supportive educational intervention
Self-care and quality of life in patients with advanced heart failure: The effect of a supportive educational intervention
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DOI：
10.1067/mhl.2000.108323
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发表时间：
2000-09-01
期刊：
影响因子：
2.8
通讯作者：
Diederiks, J
中科院分区：
文献类型：
--
作者：
Jaarsma, T;Halfens, R;Diederiks, J
目的：本研究的目的是确定支持性教育护理干预对晚期心力衰竭患者自我护理能力、自我护理行为和生活质量的影响。设计：研究设计为实验性随机分配。研究地点：该研究在荷兰马斯特里赫特大学医院进行。患者：该研究包括179名患者（平均年龄73岁，58%为男性，纽约心脏协会分类III和IV）在一所大学医院接受心力衰竭症状。结果测量：结果测量包括自我照顾能力（自我照顾代理评估量表）、自我照顾行为（心力衰竭自我照顾行为量表）、生活质量的3个维度（功能能力、症状和对疾病的心理社会适应）和整体幸福感（Cantril生活阶梯）。干预：干预患者在医院和家中接受护士的系统教育和支持。对照组患者接受常规护理。结果：自我护理能力并未因干预而改变，但干预组在随访期间的自我护理行为高于对照组。支持性教育干预对生活质量的影响有限。两组患者住院后生活质量3个维度均有改善，各随访测量结果与对照组无差异。然而，在9个月的随访中，两组在症状频次和症状困扰的减少上有差异的趋势。结论：支持性教育护理干预可有效改善晚期（纽约心脏协会III-IV类）心力衰竭患者的自我护理行为；然而，需要更密集的干预来显示改善生活质量的有效性。
OBJECTIVE: The goal of this study was to determine the effects of a supportive educational nursing intervention on self-care abilities, self-care behavior, and quality of life of patients with advanced heart failure.DESIGN: The study design was an experimental, random assignment.SETTING: The study was located at the University Hospital in Maastricht, The Netherlands.PATIENTS: The study included 179 patients (mean age 73 years, 58% men, New York Heart Association classification III and IV) admitted to a university hospital with symptoms of heart failure.OUTCOME MEASURES: Outcome measures included self-care abilities (Appraisal of Self-care Agency Scale), self-care behavior (Heart Failure Self-care Behavior Scale), 3 dimensions of quality of life (functional capabilities, symptoms, and psychosocial adjustment to illness), and overall well-being (Cantril's ladder of life).INTERVENTION: The intervention patients received systematic education and support by a nurse in the hospital and at home. Control patients received routine care.RESULTS: Self-care abilities did not change as a result of the intervention, but the self-care behavior in the intervention group was higher than the self-care behavior in the control group during follow-up. The effect of the supportive educational intervention on quality of life was limited. The 3 dimensions of quality of life improved after hospitalization in both groups, with no differences between intervention and control group as measured at each follow-up measurement. However, there was a trend indicating differences between the 2 groups in decrease in symptom frequency and symptom distress during the 9 months of follow-up.CONCLUSION: A supportive educational nursing intervention is effective in improving self-care behavior in patients with advanced (New York Heart Association class III-IV) heart failure; however, a more intensive intervention is needed to show effectiveness in improving quality of life.