对心力衰竭患者心理健康,认知功能和自我护理行为变化的分析:一项前性队列研究
Maria Jędrzejczyk1, Christopher S Lee2, Ercole Vellone1,3
1Department of Nursing, Faculty of Nursing and Midwifery, Wroclaw Medical University, Poland.
心力衰竭患者在六个月内经历了抑郁症的恶化和自我护理的下降. 保存喷射分数 (HFpEF) 的心力衰竭显示出最严重的认知衰退,强调了量身定制的护理需求.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 精神病学是一个精神病学.
背景情况:
- 心力衰竭 (HF) 影响全球数百万人,对心理健康,认知和自我护理产生重大影响.
- 这些影响在不同的HF表型 (射出分数水平) 中未得到充分研究.
- 需要进行全面的研究,以了解这些相互关联的领域在HF患者.
研究的目的:
- 为了前性地调查情感症状,认知功能和自我护理行为中的变化.
- 通过射出分数 (EF) 现型分层的HF患者在6个月内分析这些变化.
- 为了确定减少EF的HF (HFrEF),轻度减少EF的HF (HFmrEF) 和保存EF的HF (HFpEF) 之间的结果差异.
主要方法:
- 一组162名60岁以上的患有HF的患者在基线和6个月后被评估.
- 认知功能使用迷你精神状态检查 (MMSE) 进行评估.
- 使用医院焦虑和抑郁量表 (HADS) 和患者健康问卷-9 (PHQ-9) 评估了情感症状 (焦虑,抑郁).
- 用欧洲心力衰竭自我护理行为尺度 (EHFScB-9) 衡量自我护理行为.
主要成果:
- 与HFpEF相比,HFmrEF的认知障碍 (MMSE) 在HFmrEF中不那么严重 (p=0.008).
- 抑郁症的严重程度在6个月内恶化,特别是在HFpEF组 (p=0.006).
- 所有组的自我照顾能力都下降了 (EHFScB-9分数增加,p=0.035).
- 在HFrEF患者中,NT-proBNP水平最高 (p=0.001).
结论:
- 在6个月内,HF患者表现出显著的认知衰退,抑郁症状增加,自我护理减少.
- HFpEF患者表现出最明显的认知和情感障碍.
- 研究结果强调了针对高风暴表型的认知和情绪挑战的定制诊断和治疗策略的必要性.
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