SCI护理研究晨读：自我调节计划对心力衰竭患者自我保健行为的影响：一项随机对照试验背景
自我保健行为对于心力衰竭患者预防疾病进展很重要。一半以上的患者自我保健行为较差。自我调节理论强调，患者需要开始对其症状进行监测，发现自己的问题并进行适当的自我保健行为。然而，针对基于心律失常的自我调节理论的干预措施的研究有限。
目标
验证自我调节计划对心力衰竭患者自我保健行为的影响。
设计
一项随机对照试验。
参加者和场所
从中国医院的心血管门诊部招募了82名心力衰竭患者。
方法
参与者被随机分配至干预组（n?=41）或对照组（n?=41）。干预小组参加了一个为期4周的自我调节计划，其中包括一次20至30分钟的面对面个人自我调节教育课程和15至20分钟的电话跟进咨询课程，每周两次，一共四周。对照组仅接受常规门诊治疗。患者入组4周和8周时，通过心力衰竭自我护理指数来衡量自我护理行为。
结果
干预小组报告发现：在进行自我调节计划四周后，自我护理行为有所改善，包括自我维护和自信分量表得分。与对照组相比，干预组自我护理维护（β?=3.74，p?=0.01），自我护理管理（β?=6.33，p?=0.），和自我护理信心（在第4周时β=?5.15，p=0.）没有显示出显着差异。，但在自我护理管理（β=6.97，p?=0.03）和?8周时的自我护理信心（β?=6.24，p=0.）方面显示出明显更大的改善。
结论
本研究证实，自我调节计划可以有效改善心力衰竭患者的自我保健行为。有必要进行多中心随机对照试验和更多的心力衰竭患者的进一步研究，以评估该自我调节计划在各个地区和国家的效果。
关键词
心脏衰竭
自我调节
自我保健行为
AbstractBackground
Self-carebehaviourisimportantforpatientswithheartfailuretopreventdiseaseprogression.Morethanhalfofpatientshavepoorself-carebehaviour.Self-regulationtheoryemphasizesthatpatientsneedtoinitiatemonitoringoftheirsymptoms,identifytheirownproblems,andperformappropriateself-carebehaviour.However,studiesfocusedoninterventionsbasedonself-regulationtheoryforpatientswithheartfailurearelimited.
Objectives
Toinvestigatetheeffectsofaself-regulationprogrammeonself-carebehaviourinpatientswithheartfailure.
Design
Arandomizedcontrolledtrial.
ParticipantsandSetting
Eighty-twopatientswithheartfailurewererecruitedfromacardiovascularoutpatientdepartmentatateachinghospitalinnorthernTaiwan.
Methods
Participantswererandomlyassignedtotheintervention(n?=?41)orcontrolgroup(n?=?41).Theinterventiongroupparticipatedina4-weekself-regulationprogramme,includingone20-to-30-minute,face-to-faceindividualself-regulationeducationsessionand15-to20-minutetelephonefollow-upcounsellingsessionstwiceperweekforfourweeks.Thecontrolgroupreceivedonlyroutineoutpatientcare.Self-carebehaviourwasmeasuredbytheSelf-CareofHeartFailureIndexatbaseline,4weeksand8weeksafterpatientswereenrolled.
Results
Theinterventiongroupreportedimprovementsinself-carebehaviours,includingself-maintenanceandself-confidencesubscalescores,afterfourweeksoftheself-regulationprogramme.Incontrast,thecontrolgroupshowednosignificantdifferences.Comparedwiththecontrolgroup,theinterventiongroupexhibitedsignificantlygreaterimprovementsinself-caremaintenance(B?=?3.74,p?=?0.01),self-caremanagement(B?=?6.33,p?=?0.),andself-careconfidence(B?=?5.15,p?=?0.)atfourweeksbutshowedsignificantlygreaterimprovementsonlyinself-caremanagement(B?=?6.97,p?=?0.03)andself-careconfidence(B?=?6.24,p?=?0.)at8weeks.
Conclusions
Thisstudyconfirmedthataself-regulationprogrammecouldeffectivelyimproveself-carebehaviourinpatientswithheartfailure.Furtherstudieswithmulticentrerandomizedcontrolledtrialsandlargerpopulationsofheartfailurepatientsarenecessarytoevaluatetheeffectofthisself-regulationprogrammeinvariousregionsandcountries.
Tweetableabstract
Ahome-basedself-regulationprogrammecouldeffectivelyimproveself-carebehaviourinpatientswithheartfailure.
Keywords
heartfailure
self-regulation
self-carebehaviour
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