성인간호학회지 (Korean Journal of Adult Nursing)

  • 제23권3호
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  • Pages.244-254
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  • 2011
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  • 1225-4886(pISSN)
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  • 2288-338X(eISSN)
한국성인간호학회 (Korean Society of Adult Nursing)
권호 표지

만성 심부전 환자의 자가간호 이행 관련요인

Factors Influencing Adherence to Self Care in Patients with Chronic Heart Failure

  • 손연정 (순천향대학교 의과대학 간호학과) ;
  • 김선희 (고려대학교 일반대학원 간호학과) ;
  • 김기연 (연세대학교 원주의과대학 간호학과)
  • Son, Youn-Jung (Department of Nursing, College of Medicine, Soonchunhyang University) ;
  • Kim, Sun-Hee (Nursing Graduate School, Korea University) ;
  • Kim, Gi-Yon (Department of Nursing, Wonju College of Medicine, Yonsei University)
  • 투고 : 2011.04.14
  • 심사 : 2011.06.13
  • 발행 : 2011.06.30
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초록

Purpose: The objective of this study was to evaluate adherence to self-care and identify associated factors in outpatients with Heart Failure (HF). Methods: Using a cross-sectional design, a convenience sample of 249 outpatient clinic patients were recruited at S university hospital. Between October 2009 and December 2009, data were collected through questionnaires and medical record review. Results: The total mean score of adherence to self-care was $18.07{\pm}3.56$ out of a possible 45 points. Among self-care dimensions, adherence to medication and low salt diet was high, while lower adherence was reported in contact with health professionals if symptoms such as weight gain, edema and fatigue were presented. Multivariate analysis adjusted for other socio-demographic and clinical factors showed that disease knowledge related to heart failure (p<.001) and left ventricular ejection fraction (p=.027) were independent predictors of adherence to self-care. These factors explained 23% of total variance in the adherence to self-care. Conclusion: Heart failure patients with higher disease knowledge and those who have good systolic function may be more likely to engage in adherence to self-care than those with lack of disease knowledge and low contractility. Further research is needed to confirm these results and identify other predictors of adherence to self-care.

키워드

참고문헌

  1. Bandura, A. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31 , 143-164.
  2. Cameron, J., Worrall-Carter, L., Driscoll, A., & Stewart, S. (2009). Measuring self-care in chronic heart failure: A review of the psychometric properties of clinical instruments. Journal of Cardiovascular Nursing, 24 , 10-22.
  3. Chochinov, H. M., Wilson, K. G., Enns, M., & Lander, S. (1997). "Are you depressed?" Screening for depression in the terminally ill. American Journal of Psychiatry, 154, 674- 676.
  4. Chriss, P. M., Sheposh, J, Carlson, B., & Riegel, B. (2004). Predictors of successful heart failure self-care maintenance in the first three months after hospitalization. Heart & Lung, 33 , 345-353.
  5. Clark, A. M., Davidson, P., Currie, K., Karimi, M., Duncan, A. S., & Thompson, D. R. (2010). Understanding and promoting effective self-care during heart failure. Current Treatment Options in Cardiovascular Medicine, 12 (1), 1-9.
  6. Clark, A. M., Freydberg, C. N., McAlister, F. A., Tsuyuki, R. T., Armstrong, P. W., & Strain, L. A. (2009). Patient and informal caregivers' knowledge of heart failure: necessary but insufficient for effective self-care. European Journal of Heart Failure, 11 , 617-621.
  7. Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175-191.
  8. Gallagher, R. (2010). Self management, symptom monitoring and associated factors in people with heart failure living in the community. European Journal of Cardiovascular Nursing, 9 , 153-160.
  9. Han, S. W., Rye, K. H., Chae, S. C., Yang, D. H., Shin, M. S., Lee, S. H., et al. (2005). Multicenter analysis of clinical characteristics and prognostic factors of patients with congestive heart failure in Korea. Korean Circulation Journal, 35 , 357-361.
  10. Hunt, S. A., Abraham, W. T., Chin, M. H., Feldman, A. M., Francis, G. S., Ganiats, T. G., et al. (2009). 2009 focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management of heart failure in adults: A report of the american college of cardiology foundation/American heart association task force on practice guidelines: Developed in collaboration with the international society for heart and lung transplantation. Circulation, 119, e391-e479. https://doi.org/10.1161/CIRCULATIONAHA.109.192065
  11. Jaarsma, T., Arrested, K. F., Martensson, J., Dracup, K., & Stromberg, A. (2009). The European heart failure self-care behaviour scale revised into a nine-item scale (EHFScB-9). European Journal of Heart Failure, 11 , 99-105.
  12. Jaarsma, T., Van der Wal, M. H. L., Lesman-Leegte, I., Luttik, M. L., Hogenhuis, J., Veeger, N., et al. (2008). Effect of moderate or intensive disease management program on outcome in patients with heart failure. Archives of Internal Medicine, 168 , 316-324.
  13. Kato, N., Kinugawa, K., Ito, N., Yao, A., Watanabe, M., Imai, Y., et al. (2009). Adherence to self-care behavior and factors related to this behavior among patients with heart failure in Japan. Heart & Lung, 38, 398-409.
  14. Kim, G. Y. (2007). Effects of a symptom focused self-management program on symptom and functional status, health perception, and quality of life of patients with chronic heart failure. Journal of Korean Academy of Adult Nursing, 19 , 132-143.
  15. Lachs, M. S., Feinstein, A. R., Cooney, L. M., Drickamer, M. A., Margaret, A., Marottoli, R. A., et al. (1980). A simple procedure for general screening for functional disability in elderly patients. Annals of Internal Medicine, 112 , 699- 706.
  16. Lainscak, M., & Keber, I. (2005). Validation of self assessment patient knowledge questionnaire for heart failure patients. European Journal of Cardiovascular Nursing, 4 , 269-272.
  17. Lainscak, M., & Keber, I. (2006). Patients' knowledge and beta blocker treatment improve prognosis of patients from a heart failure clinic. The European Journal of Heart Failure, 8 , 187-190.
  18. Lainscak, M., Blue, L., Clark, A. L., Dahlstrom, U., Dickstein, K., Ekman, I., et al. (2011). Self-care management of heart failure: practical recommendations from the patient care committee of the heart failure association of the European society of cardiology. European Journal of Heart Failure, 13 , 115-126.
  19. Lee, C. S., Riegel, B., Driscoll, A., Suwanno, J., Moser, D. K.,Lennie, T. A., et al. (2009). Gender differences in heart failure self-care: A multinational cross-sectional study. International Journal of Nursing Studies, 46 , 1485-1495.
  20. Lennie, T. A., Worrall-Carter, L., Hammash, M., Odom-Forren, J., Rose, L. P. Smith, C. S., et al. (2008). Relationship of heart failure patients' knowledge, perceived barriers, and attitudes regarding low-sodium diet recommendations to adherence. Progress in Cardiovascular Nursing, 23 , 6-11.
  21. Macabasco-O'Connell, A., Crawford, M. H., Stotts, N., Stewart, A., & Froelicher, E. S. (2008). elf-care behaviors in indigent patients with heart failure. Journal of Cardiovascular Nursing, 23 , 223-230.
  22. Moser, D. K., & Watkins, J. F. (2008). Conceptualizing self-care in heart failure: A life course model of patient characteristics. Journal of Cardiovascular Nursing, 23 , 205-218.
  23. Riegel, B., Moser, D. K., Anker, S. D., Appel, L. J., Dunbar, S. B., Grady, K. L., et al. (2009). State of the science promoting self-care in persons with heart failure a scientific statement from the American heart association. Circulation, 120 , 1141-1163.
  24. Rutledge, T., Resi, V. A., Linke, S. E., Greenberg, B. H., & Mills, P. J. (2006). Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. Journal of the American College of Cardiology, 48 (8), 1527-1537.
  25. Schnell-Hoehn, K. N., Naimark, B. J., & Tate, R. B. (2009). Determinants of self-care Behaviors in community-dwelling patients with heart failure. Journal of Cardiovascular Nursing, 24 , 40-47.
  26. Son, Y. J., Kim, S. H., Kim, S. H., & Song, E. K. (2010). The influences of cognitive function on adherence to self care in elderly patients with heart failure. Korean Journal of Health Promotion, 10 , 61-70.
  27. Song, E. K., Kim, C. J., Yoo, I. Y., Kim, G. Y., Kim, J. H., & Ha, J. W. (2006). Factors influencing functional status in patients with heart failure. Journal of Korean Academy of Nursing, 36 , 853-862.
  28. Van der Wal, M. H. L., Jaarsma, T., Moser, D. K., Veeger, N. J., van Gilst, W. H., & Van Veldhuisen, D. J. (2006). Compliance in heart failure patients: The importance of knowledge and beliefs. European Heart Journal, 27 , 434-440.
  29. Willette, E. W., Surrells, D., Davis, L L., & Bush, C. T. (2007). Nurses' knowledge of heart failure self-management. Progress in Cardiovascular Nursing, 22 , 190-195.
  30. Yehle, K. S., & Plake, K. S. (2010). Self-efficacy and educational interventions in heart failure: A review of the literature. Journal of Cardiovascular Nursing, 25 , 175-188.