背 景心衰竭在老年人口的盛行率不斷成長，多數患者會因症狀困擾導致活動功能障礙、生活品質不佳、以及高再住院率，因此心衰竭自我照顧的衛教指導在病患住院過程中是非常重要的，然而出院後卻無法持續追蹤，這是目前台灣照護體系之一大缺失。目 的探討心衰竭自我照顧方案的執行，是否能顯著降低心衰竭病患的症狀困擾，提昇功能狀態，改善生活品質，減少再入院及急診的機會。方 ...法採類實驗性研究設計，控制組接受常規照護，實驗組接受常規照護及心衰竭自我照顧方案，個案來源為台北某醫學中心心臟內科一般病房27位診斷為心衰竭之患者，隨機分派到自我照顧計畫組（14人）或控制組（13人）。結 果追蹤三個月後，在症狀困擾（p＜ .01）、六分鐘走步測試（p ＜ .01）和生活品質（ShortForm 36台灣版，p ＜ .05），兩組有顯著差異，但在急診使用及再入院率上無顯著差異。結 論／實務應用心衰竭自我照顧方案可改善心衰竭症狀、增進活動功能和生活品質，故此計劃在臨床上是可行的，可訓練符合資格的專科護理人員負責病人的照護, Background: Prevalence of heart failure is increasing among older adults. Most heart failure patients experience distressing symptoms that lead to decreased physical functioning, poor quality of life, and a high incidence of rehospitalization. Health education about heart failure self-care (HFSC) is very important during hospitalization for these patients. However, lack of ongoing follow-up after discharge makes evaluation and disease management difficult. This is a significant problem in Taiwan.
Purpose: This study was undertaken to determine if participants with heart failure who were managed under the HFSC program had fewer distressing symptoms, better functional status,improved quality of life, and reduced hospital and emergency readmission rates compared with control group participants.Methods: This study used a quasi-experimental design with a control group that received usual care and an intervention group that received usual care plus the HFSC program. Twenty-seven
participants were recruited from 2 cardiac general wards at 1 medical center in Taipei City, Taiwan, and were randomized into intervention (n = 14) and control (n = 13) groups.Results: After 3 months, there were significant differences in symptom distress (p G .01), 6-minute walk test results (p G .01),and quality of life (using Short Form 36, Taiwan version, p G .05)between the HFSC and control groups but no significant differencesin hospital readmission and emergency department visits.
Conclusions/Implications for Practice: The HFSC program for patients with heart failure improved their heart failure symptoms and resulted in increased functional status and better quality of life. HFSC is a workable program in the clinical environment. Advanced nurse practitioners can use HFSC methods and principles to provide improved education and follow-up to heart failure patients.
