A Correlational Study of Illness Knowledge, Self-Care Behaviors, and Quality of Life in Elderly Patients with Heart Failure

以問卷調查老年心臟衰竭疾病知識、自我照顧行為與生活品質之相關性研究

10.1097/jnr.0000000000000024

劉敏慧(Min-Hui Liu)；王兆弘(Chao-Hung Wang)；黃于晏(Yu-Yen Huang)；程文俊(Wen-Jin Cherng)；王凱微(Katherine Kai-Wei Wang)

老年 ； 心臟衰竭 ； 疾病知識 ； 自我照顧行為 ； 生活品質 ； elderly ； heart failure ； illness knowledge ； self-care behaviors ； quality of life

The Journal of Nursing Research

22卷2期（2014 / 06 / 01）

136 - 145

英文

背景　醫療進步使慢性病得以控制，相形之下心臟衰竭病人日趨增加，此病是無法治癒的慢性病，病人生活歷程中活動功能受到疾病限制，嚴重影響生活品質。目的　本研究主要探討心臟衰竭病人知識、自我照顧行為與生活品質之相關性。方法　採橫斷性研究法，結構問卷為工具，研究對象為北部教學醫院門診心臟衰竭病人，共計141位心臟衰竭個案，研究時間從2008年1月到6月。結果　本研究以男性（51.8%）且年長者為主（約49.6%超過70歲），教育程度多為未受教育或 國小（69.5%）。結果顯示：⑴心臟衰竭病人疾病知識不足（正確率僅29.3%）、自我照 顧行為執行率低；⑵疾病知識與自我照顧行為、疾病生活品質具顯著相關（r = -.22, p ＜ 0.01）；⑶自我照顧行為顯著的影響因素是疾病知識與年齡（R^2 = .22）；活動功能、獨立 自理與年齡是生活品質重要影響因子（R^2 = .41）。結論／實務應用　本研究發現，較年輕的老人疾病知識、自我照顧行為與生活品質較佳；活動功能與生活獨立能力對生活品質具有顯著影響。照護實務面應強化老年心臟衰竭病患之疾病症狀管理的知識，且提升老人身體活動能力與生活獨立性，可顯著改善其生活品質。

Background: Patients with heart failure experience adverse physical symptoms that affect quality of life. The number of patients with heart failure in Taiwan has been growing in recent years. Purpose: This article examines correlations among illness knowledge, self-care behaviors, and quality of life in elderly patients with heart failure. Methods: A cross-sectional research design using three questionnaires was adopted. The study was undertaken in an outpatient department of a teaching hospital in Taiwan from January to June 2008. Potential participants aged 65 years or older were selected by a physician based on several diagnostic findings of heart failure that included an International Classification of Diseases’ code 4280 or 4289. Patients who were bedridden or had a prognosis of less than 6 months were excluded from consideration. Results: One hundred forty-one patients with heart failure were recruited. Most participants were men (51.8%), older adults (49.6% older than 71 years old), and either educated to an elementary school level or illiterate (69.5%) and have New York Heart Association class II (61.0%). Participants had an average left ventricular ejection fraction of 41.1%. The illness knowledge of participants was poor (accuracy rate: 29.3%), and most were unaware of the significance of self-care. Illness knowledge correlated with both self-care behaviors (r = -.42, p ＜ .01) and quality of life (r = -.22, p ＜ .01). Illness knowledge and age were identified as significant correlated factors of self-care behaviors (R^2 = .22); and functional class, living independently, and age were identified as significant correlated factors of quality of life (R^2 = .41). Conclusions/Implications for Practice: Participants in this study with higher self-reported self-care behaviors and quality of life were younger in age and had better illness knowledge. Furthermore, physical function and independence in daily living significantly affected quality of life. Care for patients with heart failure, particularly older adults, should focus on teaching these patients about heart failure illness and symptom management. Assisting elderly patients with heart failure to promote and maintain physical functions to handle activities of daily living independently is critical to improving patient quality of life.

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