充血性心力衰竭患者体质量管理长效依从性影响因素的质性研究  

Qualitative research on the factors affecting long-term compliance to weight management of pa- tients with congestive heart failure

作　　者：鞠阳[1] 王琪[2] 仇静波[3] 汪小华[2] 蒋青[1] 陆敏霞[1] 杨小芳[1] 

机构地区：[1]苏州大学附属第一医院,215006 [2]苏州大学护理学院 [3]中国福利会国际和平妇幼保健院

出　　处：《中国实用护理杂志》2013年第35期52-55,共4页Chinese Journal of Practical Nursing

摘　　要：目的探讨充血性心力衰竭（congestive hean failure，CHF]患者体质量管理长效依从性的影响因素，为提高患者依从性提供依据。方法应用强化理论对18例参与体质量管理I〉6个月的CHF患者进行半结构式访谈，并采用Colaizzi分析程序对访谈资料进行整理和分析。结果归纳为3个主题：（1）体质量管理行为产生的促发因素，包括对疾病的正确感知和自我效能；（2）体质量管理行为维持的正强化因素：包括早期获益、再入院、随访、家人和社会支持；（3）体质量管理行为维持的负强化因素包括长期未获益和身心障碍。上述因素的作用导致50％访谈对象的体质量管理长效依从性呈动态性波动变化。结论医护人员应在随访过程中及时发现CHF患者依从性的变化，分析影响其依从性的因素，从而把握最佳干预时机，采取针对性、多形式、多角度的健康教育以提高依从性。Objective To explore factors affecting long-term compliance to weight management （WM） of patients with congestive heart failure （CHF）and to provide evidence for improving patients com- pliance. Methods In-depth semi-structured interviews based on reinforcement theory were conducted a- mong 18 CHF patients who received WM intervention over 6 months. The data were analyzed by Calaizzi analysis program. Results Three themes were found： precipitating factors such as the correct perception of disease and self-efficacy, the factors of positive reinforcement such as early gains from WM, readmission, follow-up, family and social support, as well as the factors of negative reinforcement such as gaining nothing during long period, physical and mental disorders. These above factors made long-term compliance to WM of 50% of the participants dynamic and fluctuant. Conclusions Medical staff should identify patients compliance at different stages in time during follow-up, analyze the factors that affect their compliance, and then grasp the optimal timing of intervention to perform targeted, muhiform ard multiple health education to improve compliance.

关 键 词：充血性心力衰竭 体质量管理 依从性 质性研究 

分 类 号：R473.5[医药卫生—护理学]