心脏再同步化治疗患者自我管理现状及其影响因素  

Self-management of patients receiving cardiac resynchronization therapy and the influencing factors

作　　者：王琴[1,2] 孙国珍[1,2] 田金萍[2] 陈月香[1] 王潆潆 李新立[2] 

机构地区：[1]南京医科大学护理学院,江苏南京210029 [2]南京医科大学第一附属医院心血管内科,江苏南京210029

出　　处：《护理学杂志》2015年第21期15-18,共4页

基　　金：国家科技支撑计划课题(2011BAI11B08)

摘　　要：目的调查心脏再同步化治疗慢性心力衰竭患者自我管理现状并探讨其影响因素。方法对93例心脏再同步化治疗慢性心力衰竭患者,采用增加起搏器管理内容的心力衰竭自我护理指数量表进行调查,并分析其影响因素。结果患者自我管理各维度得分由高到底依次为:起搏器管理(61.17±21.34)分、自我护理维持(46.09±16.07)分、自我护理信心(39.43±27.49)、自我护理管理(30.48±17.69)分;自我效能、文化程度可以解释自我护理维持总变异的19.4%,自我效能、心功能分级可解释自我护理管理总变异的21.0%,自我效能可解释自我护理信心总变异的43.7%,自我效能可解释起搏器管理总变异的11.1%。结论心脏再同步化治疗慢性心力衰竭患者自我管理现状不理想,其中起搏器管理最好,自我护理管理最差。患者的自我效能、文化程度、心功能状况是其主要影响因素。应加强对心脏再同步化治疗患者起搏器管理知识及心力衰竭疾病综合管理的健康教育和指导,提高患者自我管理信心和自我管理能力。Objective To investigate self-management of patients receiving cardiac resynchronization therapy（CRT）and the influencing factors.Methods Ninety-three chronic heart failure patients receiving CRT were investigated by using the Revised Self-Care of Heart Failure Index（V6.2）,then the influencing factors were analyzed.Results The dimension scores in descending order were managing pacemakers（61.17±21.34）,self-care maintenance（46.09±16.07）,confidence in self-care（39.43±27.49）and selfcare management（30.48±17.69）.Multiple linear regressions indicated that self-efficacy and educational levels were significant predictors for self maintenance and explained 19.4% of the total variance;self-efficacy and heart function levels were significant predictors for self-care management,explaining 21.0% of the total variance;self-efficacy was also the predictors for self-confidence and pacemaker management,explaining 43.7% and 11.1% of the total variance respectively.Conclusion The self management of chronic cardiac failure patients receiving CRT is not satisfying,with management of the pacemaker being the best and self-care management being the worst.The main influencing factors are self-efficacy,educational levels and heart function.We should provide more knowledge and guidance about heart failure disease and pacemaker to the patients so as to improve their self-confidence and self-management abilities.

关 键 词：慢性心力衰竭 心脏再同步化治疗 自我管理 自我效能 心功能分级 

分 类 号：R473.5[医药卫生—护理学]