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首页> 外文期刊>The Journal of cardiovascular nursing >Effect of patient activation on self-management in patients with heart failure
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Effect of patient activation on self-management in patients with heart failure

机译：患者激活对心力衰竭患者自我管理的影响

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BACKGROUND/OBJECTIVE:: Few studies have examined whether chronic heart failure (HF) outcomes can be improved by increasing patient engagement (known as activation) in care and capabilities for self-care management. The objective was to determine the efficacy of a patient activation intervention compared with usual care on activation, self-care management, hospitalizations, and emergency department visits in patients with HF. METHODS:: This study used a randomized, 2-group, repeated-measures design. After consent was given, 84 participants were stratified by activation level and randomly assigned to usual care (n = 41) or usual care plus the intervention (n = 43). The primary outcomes and measures were patient activation using the Patient Activation Measure (PAM), self-management using the Self-Care of Heart Failure Index (SCHFI) and the Medical Outcomes Study (MOS) Specific Adherence Scale, and hospitalizations and emergency department visits. The intervention was a 6-month program to increase activation and improve HF self-management behaviors, such as adhering to medications and implementing health behavior goals. RESULTS:: Participants were primarily male (99%), were white (77%), and had New York Heart Association III stage (52%). The mean (SD) age was 66 (11) years, and 71% reported 3 or more comorbidities. The intervention group compared with the usual care group showed a significant increase in activation/PAM scores from baseline to 6 months. No significant group-by-time interactions were found for the SCHFI scales. Although the baseline MOS Specific Adherence Scale mean was lower in the intervention group, results showed a significant group-by-time effect with the intervention group improving more over time. Participants in the intervention group had fewer hospitalizations compared with the usual care group when the baseline activation/PAM level was low or high. CONCLUSION:: This study supports the importance of targeted interventions to improve patient activation or engagement in HF care. Further work is needed related to HF self-management measurement and outcomes.
机译：背景/目的：很少有研究检查慢性心力衰竭（HF）的结局是否可以通过增加患者对护理的关注（称为激活）和自我护理管理能力来改善。目的是确定与HF患者的常规激活，自我护理管理，住院和急诊就诊相比，患者激活干预的疗效。方法：本研究采用了随机分组的，重复测量的设计。征得同意后，将84位参与者按激活水平分层，并随机分配至常规护理（n = 41）或常规护理加干预（n = 43）。主要的结果和措施包括：使用患者激活措施（PAM）进行患者激活，使用心力衰竭自我护理指数（SCHFI）和医学成果研究（MOS）特定依从性量表进行自我管理以及住院和急诊就诊。该干预为期6个月，旨在增加激活并改善HF自我管理行为，例如坚持用药和实现健康行为目标。结果：参与者主要是男性（99％），白人（77％）和纽约心脏协会III期（52％）。平均（SD）年龄为66（11）岁，有71％的人报告了3种或更多的合并症。与常规护理组相比，干预组显示激活/ PAM评分从基线到6个月显着增加。对于SCHFI量表，没有发现显着的分组时间交互作用。尽管干预组的基线MOS特异性粘附量表的平均值较低，但结果显示逐组的效果显着，干预组随时间的推移而改善。当基线激活/ PAM水平低或高时，干预组的参与者的住院治疗要少于普通护理组。结论：本研究支持针对性干预对改善患者激活或参与HF护理的重要性。与HF自我管理测量和结果相关的进一步工作需要。

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