慢性心力衰竭患者及主要照顾者的生活质量研究进展
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摘要
慢性心力衰竭是各种心脏基础疾病的终末阶段,治疗效果不佳,再入院率和死亡率较高。慢性心力衰竭患者及主要照顾者生活质量处于中低水平,尤其是在生理、心理和社会等维度,并经历着高水平的焦虑和抑郁,使得患者及主要照顾者生活质量进一步下降。采用精准的药物治疗、心脏再同步化治疗、植入埋藏式心律转复除颤器及适当运动康复能改善部分慢性心力衰竭患者的生活质量。
Chronic heart failure is the end stage of different cardiovascular diseases and usually has a high readmission rate and mortality, and the current optimal treatment is dissatisfied. The quality of life of patients with chronic heart failure and their primary caregivers is at a medium-to-low level, especially in physical, psychological and social dimensions. Furthermore, chronic heart failure patients and their primary caregivers usually suffered from a relatively higher degree of anxiety and depression, which further impaired their quality of life. The quality of life about chronic heart failure patients could be improved by using accurate drug therapy, cardiac resynchronization therapy, implantable cardioverter defibrillator and proper exercise rehabilitation according to the recent studies.
Chronic heart failure is the end stage of different cardiovascular diseases and usually has a high readmission rate and mortality, and the current optimal treatment is dissatisfied. The quality of life of patients with chronic heart failure and their primary caregivers is at a medium-to-low level, especially in physical, psychological and social dimensions. Furthermore, chronic heart failure patients and their primary caregivers usually suffered from a relatively higher degree of anxiety and depression, which further impaired their quality of life. The quality of life about chronic heart failure patients could be improved by using accurate drug therapy, cardiac resynchronization therapy, implantable cardioverter defibrillator and proper exercise rehabilitation according to the recent studies.
引文
[1]葛均波,徐永健.内科学[M]. 8版.北京:人民卫生出版社, 2013.
[2] Eriksson H. Heart failure:a growing public health problem[J]. J Intern Med, 1995, 237(2):135-141.
[3] Stewart S, Macintyre K, Hole D J, et al. More'malignant'than cancer?Five-year survival following a first admission for heart failure[J]. Eur J Heart Fail, 2001, 3(3):315-322.
[4]钱海兰.居家慢性心力衰竭患者和家庭照顾者疾病管理及生活质量的调查[D].上海:复旦大学, 2012.
[5] Benjamin E J, Virani S S, Callaway C W, et al. Heart disease and stroke statistics-2018 update:a report from the American Heart Association[J]. Circulation, 2018, 137(12):e67-e492.
[6] Vellone E, Chung M L, Cocchieri A, et al. Effects of self-care on quality of life in adults with heart failure and their spousal caregivers:testing dyadic dynamics using the actor-partner interdependence model[J].J Fam Nurs, 2014, 20(1):120-141.
[7]陈伟伟,高润霖,刘力生,等.?中国心血管病报告2016?概要[J].中国循环杂志, 2017, 32(6):521-530.
[8] Muntwyler J.[Epidemiology of heart failure][J].[in German]. Ther Umsch, 2000, 57(5):279-283.
[9] Quinn C, Dunbar S B, Higgins M. Heart failure symptom assessment and management:can caregivers serve as proxy?[J]. J Cardiovasc Nurs, 2010, 25(2):142-148.
[10] Grant J S, Graven L J. Problems experienced by informal caregivers of individuals with heart failure:an integrative review[J]. Int J Nurs Stud, 2018, 80:41-66.
[11] Ponikowski P, Voors A A, Anker S D, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure:The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology(ESC)Developed with the special contribution of the Heart Failure Association(HFA)of the ESC.[J]. Eur Heart J, 2016, 37(27):2129-2200.
[12]黄莉莉,胡光玲.老年心力衰竭患者感知控制力与生活质量的相关性[J].中国老年学杂志, 2017, 37(2):466-468.
[13]杨贝贝,郑战战,吴圣佳,等.慢性稳定性心力衰竭患者症状群分类的研究[J].中国护理管理, 2018, 18(2):185-191.
[14] Jurgens C Y, Fain J A, Riegel B. Psychometric testing of the heart failure somatic awareness scale[J]. J Cardiovasc Nurs, 2006, 21(2):95-102.
[15] Cameron J, Worrall-Carter L, Riegel B, et al. Testing a model of patient characteristics, psychologic status, and cognitive function as predictors of self-care in persons with chronic heart failure[J]. Heart Lung, 2009, 38(5):410-418.
[16] Riegel B, Vaughan Dickson V, Goldberg L R, et al. Factors associated with the development of expertise in heart failure self-care[J]. Nurs Res, 2007, 56(4):235-243.
[17] Azevedo I G, Vieira E M D A, Nogueira I D B, et al. Correlation between sleep and quality of life in patients with heart failure[J]. Fisioter Pesqui, 2015, 22(2):148-154.
[18] Mcentee M L, Cuomo L R, Dennison C R. Patient-, provider-, and system-level barriers to heart failure care[J]. J Cardiovasc Nurs, 2009,24(4):290-298.
[19] Str?mberg A. The crucial role of patient education in heart failure[J]. Eur J Heart Fail, 2014, 7(3):363-369.
[20] Carlson B, Riegel B, Moser D K. Self-care abilities of patients with heart failure[J]. Heart Lung, 2001, 30(5):351-359.
[21] Wu J R, Moser D K, Chung M L, et al. Predictors of medication adherence using a multidimensional adherence model in patients with heart failure[J]. J Card Fail, 2008, 14(7):603-614.
[22] Bennett S J, Hays L M, Embree J L, et al. Heart Messages:a tailored message intervention for improving heart failure outcomes[J]. J Cardiovasc Nurs, 2000, 14(4):94-105.
[23] Rohrbaugh M J, Shoham V, Coyne J C, et al. Beyond the"self"in self-efficacy:spouse confidence predicts patient survival following heart failure[J]. J Fam Psychol, 2004, 18(1):184-193.
[24] Dickson V V, Deatrick J A, Riegel B. A typology of heart failure selfcare management in non-elders[J]. Eur J Cardiovasc Nurs, 2008, 7(3):171-181.
[25] Riegel B, Moser D K, Anker S D, et al. State of the science:promoting self-care in persons with heart failure:a scientific statement from the American Heart Association[J]. Circulation, 2009, 120(12):1141-1163.
[26] Riegel B, Lee C S, Dickson V V, et al. Self care in patients with chronic heart failure[J]. Nat Rev Cardiol, 2011, 8(11):644-654.
[27] Dickson V V, Worrall-Carter L, Kuhn L, et al. Whose job is it? Gender differences in perceived role in heart failure selfcare[J]. J Nurs Healthc Chronic Illn, 2011, 3(2):99-108.
[28] Dewalt D A, Malone R M, Bryant M E, et al. A heart failure selfmanagement program for patients of all literacy levels:a randomized,controlled trial[ISRCTN11535170][J]. BMC Health Serv Res, 2006, 6(1):30.
[29] Kavalieratos D, Gelfman L P, Tycon L E, et al. Palliative care in heart failure:rationale, evidence, and future priorities[J]. J Am Coll Cardiol, 2017, 70(15):1919-1930.
[30] Jorge A J L, Rosa M L G, Correia D M D S, et al. Evaluation of quality of life in patients with and without heart failure in primary care[J].Arq Bras Cardiol, 2017, 109(3):248-252.
[31] Aggelopoulou Z, Fotos N V, Chatziefstratiou A A, et al. The level of anxiety, depression and quality of life among patients with heart failure in Greece[J]. Appl Nurs Res, 2017, 34:52-56.
[32] Sohani Z N, Samaan Z. Does depression impact cognitive impairment in patients with heart failure?[J]. Cardiol Res Pract, 2012, 2012:524325.
[33] Alhurani A S, Dekker R L, Abed M A, et al. The association of comorbid symptoms of depression and anxiety with all-cause mortality and cardiac rehospitalization in patients with heart failure[J]. Psychosomatics, 2015, 56(4):371-380.
[34] Nassif M E, Tang Y, Cleland J G, et al. Precision medicine for cardiac resynchronization:predicting quality of life benefits for individual patients-an analysis from 5 clinical trials[J]. Circ Heart Fail, 2017, 10(10):e004111.
[35] Gopinathannair R, Lerew D R, Cross N J, et al. Longitudinal changes in quality of life following ICD implant and the impact of age, gender, and ICD shocks:observations from the INTRINSIC RV trial[J]. J Interv Card Electrophysiol, 2017, 48(3):291-298.
[36] H?gglund E, Hagerman I, Dencker K, et al. Effects of yoga versus hydrotherapy training on health-related quality of life and exercise capacity in patients with heart failure:A randomized controlled study[J].Eur J Cardiovasc Nurs, 2017, 16(5):381-389.
[37] Hu X, Hu X, Su Y, et al. Quality of life among primary family caregivers of patients with heart failure in Southwest China[J]. Rehabil Nurs, 2018, 43(1):26-34.
[38] Pressler S J, Gradus-Pizlo I, Chubinski S D, et al. Family caregiver outcomes in heart failure[J]. Am J Crit Care, 2009, 18(2):149-159.
[39] Bidwell J T, Higgins M K, Reilly C M, et al. Shared heart failure knowledge and self-care outcomes in patient-caregiver dyads[J]. Heart Lung, 2018, 47(1):32-39.
[40] Luttik M L, Jaarsma T, Veeger N J, et al. For better and for worse:quality of life impaired in HF patients as well as in their partners[J].Eur J Cardiovasc Nurs, 2005, 4(1):11-14.
[41] Dunlay S M, Roger V L, Weston S A, et al. Patient and spousal health and outcomes in heart failure[J]. Circ Heart Fail, 2017, 10(10):004088.
[42] Gary R, Dunbar S B, Higgins M, et al. An intervention to improve physical function and caregiver perceptions in family caregivers of persons with heart failure[J]. J Appl Gerontol, 2018:0733464817746757.doi:10.1177/0733464817746757.[Epub ahead of print].
[2] Eriksson H. Heart failure:a growing public health problem[J]. J Intern Med, 1995, 237(2):135-141.
[3] Stewart S, Macintyre K, Hole D J, et al. More'malignant'than cancer?Five-year survival following a first admission for heart failure[J]. Eur J Heart Fail, 2001, 3(3):315-322.
[4]钱海兰.居家慢性心力衰竭患者和家庭照顾者疾病管理及生活质量的调查[D].上海:复旦大学, 2012.
[5] Benjamin E J, Virani S S, Callaway C W, et al. Heart disease and stroke statistics-2018 update:a report from the American Heart Association[J]. Circulation, 2018, 137(12):e67-e492.
[6] Vellone E, Chung M L, Cocchieri A, et al. Effects of self-care on quality of life in adults with heart failure and their spousal caregivers:testing dyadic dynamics using the actor-partner interdependence model[J].J Fam Nurs, 2014, 20(1):120-141.
[7]陈伟伟,高润霖,刘力生,等.?中国心血管病报告2016?概要[J].中国循环杂志, 2017, 32(6):521-530.
[8] Muntwyler J.[Epidemiology of heart failure][J].[in German]. Ther Umsch, 2000, 57(5):279-283.
[9] Quinn C, Dunbar S B, Higgins M. Heart failure symptom assessment and management:can caregivers serve as proxy?[J]. J Cardiovasc Nurs, 2010, 25(2):142-148.
[10] Grant J S, Graven L J. Problems experienced by informal caregivers of individuals with heart failure:an integrative review[J]. Int J Nurs Stud, 2018, 80:41-66.
[11] Ponikowski P, Voors A A, Anker S D, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure:The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology(ESC)Developed with the special contribution of the Heart Failure Association(HFA)of the ESC.[J]. Eur Heart J, 2016, 37(27):2129-2200.
[12]黄莉莉,胡光玲.老年心力衰竭患者感知控制力与生活质量的相关性[J].中国老年学杂志, 2017, 37(2):466-468.
[13]杨贝贝,郑战战,吴圣佳,等.慢性稳定性心力衰竭患者症状群分类的研究[J].中国护理管理, 2018, 18(2):185-191.
[14] Jurgens C Y, Fain J A, Riegel B. Psychometric testing of the heart failure somatic awareness scale[J]. J Cardiovasc Nurs, 2006, 21(2):95-102.
[15] Cameron J, Worrall-Carter L, Riegel B, et al. Testing a model of patient characteristics, psychologic status, and cognitive function as predictors of self-care in persons with chronic heart failure[J]. Heart Lung, 2009, 38(5):410-418.
[16] Riegel B, Vaughan Dickson V, Goldberg L R, et al. Factors associated with the development of expertise in heart failure self-care[J]. Nurs Res, 2007, 56(4):235-243.
[17] Azevedo I G, Vieira E M D A, Nogueira I D B, et al. Correlation between sleep and quality of life in patients with heart failure[J]. Fisioter Pesqui, 2015, 22(2):148-154.
[18] Mcentee M L, Cuomo L R, Dennison C R. Patient-, provider-, and system-level barriers to heart failure care[J]. J Cardiovasc Nurs, 2009,24(4):290-298.
[19] Str?mberg A. The crucial role of patient education in heart failure[J]. Eur J Heart Fail, 2014, 7(3):363-369.
[20] Carlson B, Riegel B, Moser D K. Self-care abilities of patients with heart failure[J]. Heart Lung, 2001, 30(5):351-359.
[21] Wu J R, Moser D K, Chung M L, et al. Predictors of medication adherence using a multidimensional adherence model in patients with heart failure[J]. J Card Fail, 2008, 14(7):603-614.
[22] Bennett S J, Hays L M, Embree J L, et al. Heart Messages:a tailored message intervention for improving heart failure outcomes[J]. J Cardiovasc Nurs, 2000, 14(4):94-105.
[23] Rohrbaugh M J, Shoham V, Coyne J C, et al. Beyond the"self"in self-efficacy:spouse confidence predicts patient survival following heart failure[J]. J Fam Psychol, 2004, 18(1):184-193.
[24] Dickson V V, Deatrick J A, Riegel B. A typology of heart failure selfcare management in non-elders[J]. Eur J Cardiovasc Nurs, 2008, 7(3):171-181.
[25] Riegel B, Moser D K, Anker S D, et al. State of the science:promoting self-care in persons with heart failure:a scientific statement from the American Heart Association[J]. Circulation, 2009, 120(12):1141-1163.
[26] Riegel B, Lee C S, Dickson V V, et al. Self care in patients with chronic heart failure[J]. Nat Rev Cardiol, 2011, 8(11):644-654.
[27] Dickson V V, Worrall-Carter L, Kuhn L, et al. Whose job is it? Gender differences in perceived role in heart failure selfcare[J]. J Nurs Healthc Chronic Illn, 2011, 3(2):99-108.
[28] Dewalt D A, Malone R M, Bryant M E, et al. A heart failure selfmanagement program for patients of all literacy levels:a randomized,controlled trial[ISRCTN11535170][J]. BMC Health Serv Res, 2006, 6(1):30.
[29] Kavalieratos D, Gelfman L P, Tycon L E, et al. Palliative care in heart failure:rationale, evidence, and future priorities[J]. J Am Coll Cardiol, 2017, 70(15):1919-1930.
[30] Jorge A J L, Rosa M L G, Correia D M D S, et al. Evaluation of quality of life in patients with and without heart failure in primary care[J].Arq Bras Cardiol, 2017, 109(3):248-252.
[31] Aggelopoulou Z, Fotos N V, Chatziefstratiou A A, et al. The level of anxiety, depression and quality of life among patients with heart failure in Greece[J]. Appl Nurs Res, 2017, 34:52-56.
[32] Sohani Z N, Samaan Z. Does depression impact cognitive impairment in patients with heart failure?[J]. Cardiol Res Pract, 2012, 2012:524325.
[33] Alhurani A S, Dekker R L, Abed M A, et al. The association of comorbid symptoms of depression and anxiety with all-cause mortality and cardiac rehospitalization in patients with heart failure[J]. Psychosomatics, 2015, 56(4):371-380.
[34] Nassif M E, Tang Y, Cleland J G, et al. Precision medicine for cardiac resynchronization:predicting quality of life benefits for individual patients-an analysis from 5 clinical trials[J]. Circ Heart Fail, 2017, 10(10):e004111.
[35] Gopinathannair R, Lerew D R, Cross N J, et al. Longitudinal changes in quality of life following ICD implant and the impact of age, gender, and ICD shocks:observations from the INTRINSIC RV trial[J]. J Interv Card Electrophysiol, 2017, 48(3):291-298.
[36] H?gglund E, Hagerman I, Dencker K, et al. Effects of yoga versus hydrotherapy training on health-related quality of life and exercise capacity in patients with heart failure:A randomized controlled study[J].Eur J Cardiovasc Nurs, 2017, 16(5):381-389.
[37] Hu X, Hu X, Su Y, et al. Quality of life among primary family caregivers of patients with heart failure in Southwest China[J]. Rehabil Nurs, 2018, 43(1):26-34.
[38] Pressler S J, Gradus-Pizlo I, Chubinski S D, et al. Family caregiver outcomes in heart failure[J]. Am J Crit Care, 2009, 18(2):149-159.
[39] Bidwell J T, Higgins M K, Reilly C M, et al. Shared heart failure knowledge and self-care outcomes in patient-caregiver dyads[J]. Heart Lung, 2018, 47(1):32-39.
[40] Luttik M L, Jaarsma T, Veeger N J, et al. For better and for worse:quality of life impaired in HF patients as well as in their partners[J].Eur J Cardiovasc Nurs, 2005, 4(1):11-14.
[41] Dunlay S M, Roger V L, Weston S A, et al. Patient and spousal health and outcomes in heart failure[J]. Circ Heart Fail, 2017, 10(10):004088.
[42] Gary R, Dunbar S B, Higgins M, et al. An intervention to improve physical function and caregiver perceptions in family caregivers of persons with heart failure[J]. J Appl Gerontol, 2018:0733464817746757.doi:10.1177/0733464817746757.[Epub ahead of print].