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首页> 外文期刊>Patient Preference and Adherence >The dynamics of self-care in the course of heart failure management: data from the IN TOUCH study
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The dynamics of self-care in the course of heart failure management: data from the IN TOUCH study

机译：心力衰竭治疗过程中自我护理的动态：来自IN TOUCH研究的数据

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Introduction: Self-care is an important patient-reported outcome (PRO) for heart failure (HF) patients, which might be affected by disease management and/or telemonitoring (TM). The number of studies reporting the influence of TM on self-care is limited. Aims: This study aimed: to assess whether TM, in addition to information-and-communication-technology (ICT)-guided disease management system (ICT-guided DMS), affects self-care behavior; to evaluate the dynamics of self-care during the study; to investigate factors contributing to self-care changes; and to identify a patient profile that predisposes the patient to improvement in self-care. Methods: In the INnovative ICT-guided-DMS combined with Telemonitoring in OUtpatient clinics for Chronic HF patients (IN TOUCH) study, 177 patients were randomized to either ICT-guided DMS or TM+ICT-guided DMS, with a follow-up of 9?months. The current analysis included 118 participants (mean age: 69±11.5?years; 70% male) who filled the following PRO instruments: the nine-item European Heart Failure Self-care Behaviour scale (EHFScBs), Hospital Anxiety and Depression scale (HADs), and Minnesota Living with HF Questionnaire (MLHFQ). Results: The baseline level of self-care was better in the TM+ICT-guided-DMS group (n=58) compared to ICT-guided-DMS group (n=60, p =0.023). Self-care behavior improved in the ICT-guided-DMS group ( p 28, or from 17 to 28 with concomitant HADs depression subscale (HADs_D) score ≤8, demonstrated the greatest potential to improve self-care during the study. Conclusion: TM did not have an advantage on self-care improvement. Poor physical aspect of quality of life, lower LVEF, and lower NYHA class were associated with self-care worsening. The greatest self-care improvement may be achieved in those patients who have low or medium initial self-care level in the absence of depression.
机译：简介：自我护理是心力衰竭（HF）患者重要的患者报告结局（PRO），可能会受到疾病管理和/或远程监控（TM）的影响。报告TM对自我保健影响的研究数量有限。目的：本研究旨在：评估TM除信息和通信技术（ICT）指导的疾病管理系统（ICT指导的DMS）之外是否还会影响自我护理行为;在研究过程中评估自我保健的动力;调查促成自我保健改变的因素;并确定使患者易于自我保健的患者档案。方法：在创新型ICT指导的DMS与远程门诊就诊的慢性HF患者（IN TOUCH）研究中，将177名患者随机分为ICT指导的DMS或TM + ICT指导的DMS，并随访9个月。当前的分析包括118位参与者（平均年龄：69±11.5岁; 70％的男性），他们参加了以下PRO工具：九项欧洲心力衰竭自我保健行为量表（EHFScBs），医院焦虑和抑郁量表（HADs） ），以及明尼苏达州的《 HF问卷调查表》（MLHFQ）。结果：与ICT指导的DMS组（n = 60，p = 0.023）相比，TM + ICT指导的DMS组（n = 58）的自我护理基线水平更好。 ICT指导的DMS组的自我保健行为得到了改善（第28页，或从17上升至28，伴有HADs抑郁量表（HADs_D）得分≤8，证明在研究期间改善自我保健的最大潜力。结论：TM生活质量的低下，LVEF的降低和NYHA等级的降低与自我保健的恶化有关，自我保健的改善最大的患者可能是自我保健的改善。在没有抑郁的情况下，初始自我保健水平中等。

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