عوامل موثر در تبعیت از رژیم درمانی و ارتباط باور بهداشتی و آگاهی با آن در بیماران زن مبتلا به نارسایی قلبی

نوع مقاله : علمی پژوهشی

نویسنده

عضوهیئت علمی(مربی)، گروه پرستاری، اتاق عمل و هوشبری، دانشکده پزشکی، واحد تبریز، دانشگاه آزاد اسلامی ، تبریز، ایران.(نویسنده مسئول)ne_ezzati@iaut.ac.ir

چکیده

نارسایی قلبی از شایع‌ترین بیماری‌های مزمن دنیا است وهزینه‌های زیادی به سیستم‌های بهداشتی دارد. ارتقای پذیرش رژیم درمانی روش موثر در پیشگیری از نارسایی قلبی و افزایش بقای بیماران است. این مطالعه با هدف بررسی درمان و باور بهداشتی و آگاهی در بیماران مبتلا به نارسایی قلب انجام گرفت.این پژوهش یک مطالعه توصیفی همبستگی بود که 250 بیمار مبتلا به نارسایی قلبی پرسش‌نامه‌ها را تکمیل کردند. پرسش‌نامه‌ها شامل 4 بخش متغیرهای دموگرافیک و بالینی، پرسش‌نامه اصلاح شده تبعیت درمان نارسایی قلب، مقیاس آگاهی و باور نارسایی قلب بود. در تجزیه و تحلیل داده‌ها از نرم افزار SPSS 22 آمار توصیفی و استنباطی، تی مستقل، آنووا، خی دو، ضریب همبستگی پیرسون، رگرسیون لجستیک استفاده شد. اکثریت واحدهای پژوهش دارای پذیرش متوسط از رژیم درمانی بوده و اکثریت آگاهی از نارسایی قلب داشتند. در این پژوهش بین باور بیماران از منافع و منابع پذیرش درمان ارتباط معنی‌دار مشاهده گردید نتایج حاکی از آن بود که میان تبعیت رژیم درمانی و برخی مشخصات دموگرافیک ارتباط معنی‌دار آماری وجود داشت. نتایج پژوهش نشان داد که تبعیت در حیطه‌های رژیم دارویی، محدودیت سدیم و قرار ملاقات با پزشک بالا بود. اکثریت بیماران آگاهی کمی درباره بیماری خود و رژیم نارسایی قلب داشتند. تاکید بر روش های خودمراقبتی مانند توزین روزانه، توضیح بیمار درباره چگونگی توجه به خودکنترلی در راستای پیشگیری از تشدید علایم نارسایی قلب از اهمیت بسزایی برخوردار است. مداخلات درمانی و مراقبتی در راستای مشکلات تجربه شده بیماران طراحی شوند.
واژه های کلیدی: تبعیت، رژیم درمانی ، باور بهداشتی، آگاهی، بیماری نارسایی قلبی

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Associated factors about Treatment regime Compliance and correlation with Health beliefs and Knowledge in Woman patients with Chronic Heart Failure

نویسنده [English]

  • Nayele Ezzati
Science member(Instructor), Department of Nursing, Operating room and Anesthesia, Department of Medical, Tabriz Branch, Islamic Azad University, Tabriz, Iran
چکیده [English]

Introduction: Heart failure as one of the most common chronic disease in the world imposes high costs on health system. Promotion of treatment regimen compliance is more effective factor in order to prevent heart failure and increase the survival of patients. This study was conducted to determine heart failure compliance with treatment regimen and related factors contains health belief and knowledge.
Methods: This study was a descriptive – analytic study that 250 women patients with chronic heart failure completed the questionnaire, that was included 4 sections of demographic and clinical variables, revised heart failure compliance, heart failure knowledge scale and heart failure belief scale. Data analyses were performed using descriptive and analytical statistical methods, independent t test, ANOVA, chi-2, Pearson correlation coefficient tests, and logistic regression by the software SPSS version 22.
Results: The most of patients had mean level compliance from their treatment regime and good knowledge about their illness. There was a significant relationship between patients, s belief and compliance advantages and disadvantages. The results showed significant relationship between some demographic characteristics and treatment regime.
Conclusion: In this research, compliance with medication, sodium restriction, physician visit were high.  The most of patients had a little knowledge about their illness self-care. Emphasis in self-care methods such as daily weighting, the kinds of self-controlling in order to prevent worsening signs and symptoms of heart failure is particularly important.   

کلیدواژه‌ها [English]

  • Treatment regime
  • Compliance
  • Chronic Heart Failure
  • Health belief
  • -        Abbasi, A., Asayesh, H., Hoseini, A., Ghorbani,M., Abdollahi, A., Rouhi, G., (2016), The Relationship between Functional Ability and Quality of Life in Patients with Heart Failure, Iran Southern Medical Journal, 13( 9), p:13-40.[In Persian]

    -        Abootalebi, G., Vosooghi, N., Mohammadnejad, E., Namadi, M.,Akbari, m., (2017), Study of the Self-care Agency in Patients with Heart Failure, Journal of Critical Care Nursing, 4 (4), p: 203-208.

    -        Ahrari, S.E., (2015), The Relationship between Depression and Adherence to Treatment Regimens in Patients with Type 2 Diabetes Admitted to 29 Bahman Hospital in Gonabad, Scientific Research Journal of Shahed University, 22 (17), p: 71 – 77.[In Persian]

    -        Alosco, M.L., Spitznagel, M.B., Vandulmen, M., Raz, N., Cohen R, Sweet, l.h., etal, (2012), Cognitive Function and Treatment Adherence in Older Adults with Heart Failure, Psychosom Med Journal, 74 (9), p: 65-74.

    -        Alosco, M.L., Spitznagel, M.B., Vandulmen, M., Raz, N., Et al. (2012), Cognitive Function and Treatment Adherence in Older adults with Heart Failure, Psychosomatic Medicin Journal, 74 (9), p: 965-973.

    -        Amin, Amin., (2020), International Heart Failure Congress, Http://www.YJC.ir/news.

    -        Barlow, J., Wright, C., Sheasby, J., Turner, A., Hainsworth, J., 2012, Self-Management Approaches for People with Chronic Conditions, Patient Educations Journal, 48 (10), p: 177-187.

    -        Black, G., Davis, B.A., Heathcotte, K., Mitchell, N., Sanderson, C., (2016), The Relationship between Spirituality and Compliance in Patients with Heart Failure, Progress Cardiovasculare Nursing, 21 (1), p: 128-133.

    -        Bosworth, H.B., (2014), Two Self – management Interventions to Improve Hypertension Control: A Randomized Trial. Annals of Internal Medicine, 151 (10), p: 687 – 695.

    -        Browne, T., Merighi, J.R., (2015), Barriers to Adult Hemodialysis Patients Self-management of Oral Medications, American Journal of Kidney Disease, 56 (3), p: 547 – 557.

    -        Buckle, J., Sharkey, p., Myriski P., Smout, R., Horn, S., (2017), Improving Outcomes for Patients Hospitalized with CHF, Managed Care Quarterly, 10 (6), p: 30-40.

    -        Carlson, B., Riegel, B., Moser, D., (2011), Self-care Abilities of Patients with Heart Failure, Heart and Lung: The Journal of Acute and Critical Care, 30 (5), p: 351 - 359.

    -        Cheraghi, M., Davari, dolatabadi, E., Salavati, M., Moghimbeigi, A., (2012), Association between Perceived Social Support and Quality of Life in Patients with Heart Failure, Iran Journal of Nursing, 25 (75), p: 21-31.[In Persian]

    -        Chung, M.L., Lennie, T.A., Dejong, M., W.U., Riegel, B., Moser, D.K., (2018), Patients Differ in their Abillity to Self monitor Adherence to a Low-sodium diet versus Medication, Journal of Cardiac Failure, 14 (5), p: 114-120.

    -        Chung, M.L., Moser, D.K., Lennie, T.A., (2013), Adherence to the Low Sodium Diet in Patients with Heart Failure is Best when Family members also Follow the Diet. Journal of Cardiac Failure, 15 (9), p: 43-53.   

    • Connell, J.B., (2014), The Economic Burden of the Heart Failure, Clinical Cardiology, 23 (3), p: 15-24.

    -        Dehganzadeh, Shadi., Jaefaragaee,  Fatemeh., Shishegaran, Maesume., (2015), Treatment Admission and Effective factors in Heart Failure Patients, Nursing Research, 9 (4), p: 36-46.[In Persian]

    -        Evagelista, L.S., Berg, J., Dracup, K., (2014), Relationship between Psychosocial Variables and Compliance in Patients with Heart Failure, Heart and Lung Journal, 30 (4), p: 294-301.

    -        Evangelista, L.S., Dracup, K.A., (2014), Closer Look at Compliance Research in Heart Failure Patients in the Last decade, Progressive Cardiovascular Nursing, 15 (3), p:97-103.

    -        Franco, G., Biagio,F., Battista, Z.G., Giuseppe, S., Ercole, V., (2014), Adherence to Guidelines in the Treatment of  Patients with Chronic Heart Failure, Journal of Cardiovascular Medicine, 15 (1), p: 491-7.

    -        Hamidi, Azar., Rshidlamir, Amir., Khanjei, Rambod.,  (2020), The Effect of Aerobic-resistance Training on Plasma Levels of  bFGF in coronary Artery Disease After CABG, Journal of Arak University of Medical Science, 23 (3), p: 314 -324.

    -        Hekmatpour, D., Mohammadi, E., Ahmadi, f., Arefi, S.H., (2015), Termination of professional responsibility: Exploring the process of discharging patients with Heart Failure from hospitals, International Journal of Nursing practice, 16 (3), p: 389-96. [In Persian]

    -        Hekmatpour, D., Mohammadi, E., Ahmadi, F., Arefi, S.H., (2018), Non-C0mpliance factors of Congestive Heart Failure Patient Readmitted in Cardiac Care Units, Iranian Journal of Critical Nursing, 3(4), P: 91-98.

    -        Heo, S., Moser, D.K., Lennie, T.A., Riegel, B., Chung, M.L., (2013), Gender differences and Factors related to Self-care Behaviors: A Cross-sectional Correlational Study of Patients with Heart Failure. International Journal of Nursing Studies, 45 (12), p: 1807-1815.

    -        Heo, S., Moser, D.K., Lennie, T.A., Zambroski, C.H., Chung, M,L., (2017), A Comparison of Health – related Quality of Life between Older adults with Heart Failure and Healthy Older adults, Heart and Lung: The Journal of Acute and Critical Care, 36 (1), p: 36 (10). P: 16-24.

    -        Heydan, J., (2018), Introduction to Health Behavior Theory, London, Jones and Bartlett Publishers.

    -        Jaarsma, T., Abusaad, H.H., Dracup, K., Halfens, R., (2014), Self-care Behavior of  Patients with Heart Failure, Scandinavian Journal of Caring Science, 14 (2), p: 112-119.

    -        Jaarsma, T., Nikolova-simons, M., Vanderwal, M.H., (2012), Nurses, Strategies to Address self- care aspects related to Medication; Adherence and Symptom  Recognition in Heart Failure patients: An In depth look, Heart and Lung: The Journal of Acute and Critical Care, 21  (32), p: 583-930.

    -        Jaarsma, T.,Stromberg, A., Matensson, J., Dracup, K., (2013), Development and Testing of the European  Heart Failure Self-care Scale, European Journal of Heart Failure, 5 (3), p: 363-370.

    -        Joekes, k.S., Maes, M.,(2017), Predicting Quality of Life and Self – management from Dialyze Support and Overprotection after Myocardial Infarction, British Journal of Health Psychology, 12 (4), p: 473 -489.

    -        Karimi, S., Javadi, M,. Jafarzadeh, F.,( 2012), Economic Burden and Costs of Chronic Disease in Iran and the World, Health Information Management, 8 (7), P: 84-96 .[In Persian]

    -        Kato, n., Kinugawa, K., Ito, N., Yao, A., Watanabe, M., Imai, Y., et al. (2015), Adherence to Self-care Behavior and Factors related to this behavior among patients with Heart Failure in Japan,  Heart and Lung: The Journal of Acute and Critical Care, 38 (1), p: 398-409.

    -        Kessing, D., Denollet, J., Widdershoven, J., Kupper, N., (2016), Fatigue and Self-care in Patients with Chronic Heart Failure, European Journal of Cardiovascular Nursing, 15 (5), p: 337-344.

    -        Kommuri, N.V., Johnson, M.L., Koelling, T.M., Relationship between Improvements in Heart Failure Patient Disease Specific Knowledge and Clinical Events as part of a Randomized Controlled Trial, Patient Education Counseling, 86 (2), p: 233-238.

    -        Lehan, E., Mccarthy, G., (2017), Intentional and Unintentional Medication Non-adherence: A Comprehensive Framework for Clinical Research and Practice: A Discussion paper, International Journal of Nursing Studies, 44 (8), p: 77-96.

    -        Leong, K., Goh, P., Chag, B., Limgamanaicker, J., (2017), Heart Failure Cohort in Sinapore with Defined criteria: Clinical Characteristics and Prognosis in a multi-ethnic hospital based Cohort in Singapore, Singapore Medical Journal, 48 (17), p: 407-414.

    -        Lorig, K.R., Sobel, D.S., Stewart, A.L., Brown, J.R., Bandura, A., Ritter, P., (2016), Evidence Suggesting that A Chronic Disease Self-Management Program can Improve Health Status while Reducing Hospitalization: A Randomized Trail, Medical Care Journal, 37 (5), P: 5-14.

    -        Lorig, K.R., Sobel, D.S., Stewart, A.L., Brown, J.R., Bandura, A., Ritter, P., (2012), Evidence Suggesting that a Chronic Disease self-management Programs Improve Health status while Reducing Hospitalization: A Randomized Trail, Med Care Journal, 5 (12), p: 5-14.

    -        Mansouri, K.H., Hasavari, F., Sedghi, Sabet, M., Kazemnejade, L., (2018), Self-care Status and its Related Factors in Patients with Heart Failure, Journal of Health and Care, 19 (4), p: 232 – 241.[In Persian]

    -        Marti, C., Georgiopoulou, V., Giamouzis, G., Cole, R., Deka, A., Tang, W., (2013), Patient reported Selective Adherence to Heart Failure Self-care Recommendations: A Prospective Cohort Study , The Atlanta Cardiomyopathy Consortium, Congestive Heart Failure, 19 (1), p: 16 -24.

    -        Mukotekwa, C., Carson, E., (2017), Improving the Discharge Planning Process: A Systems Study, Journal of  Research in Nursing, 12 (3), P: 67-86.

    -        Niakan, M. (2012), Study of Effect of Depressive symptoms severity on Self-care Behavior in Patients Experienced Myocardial Infarction in the first 30 days in Dr.Heshmat Hospital 1390 – 91 [Thesis for Master degree in Nursing], Guilan Unversity of Medical Science: Shahid Beheshti College of Nursing and Midwifery.

    -        Oksel, E., Akbiyik, A., Kocak, G., (2014), Self-care Behavior Analysis of  Patients with Chronic Heart Failure, European Journal of Cardiovascular Nursing, 31 (7), p: 22-43.

    -        Pang, S.W., Chang, A., (2014), Psychosocial Correlates of Fluid Compliance among Chinese Hemodialysis patients, Advance Nursing Journal, 35 (3), p: 691-698.

    -        Parvizi, Rezayat., (2020), The 17th Heart Health Congress, Iranian Students News Agency. Http://www.isna.ir/news.

    -        Pasma, A., Schenk, L., Timman, R., Vants, S.A., Apple, C., Noort, Vanderland, W.,( 2015), Does Non-adherence to DMRARDs Influence Hospital related Health-care Costs for Early Arthritis in the First year of Treatment? Non Adherence to Disease Modifying Anti-rheumatic Drugs in Early Arthritis, Journal of Clinical Nursing, 39 (1), P:32 -42.

    -        Rahimi, F., Gharib, A., Beyrami, M., Naseri, O., (2014), Effect of Self-care Education on Self-Efficacy in Patients Undergoing Hemodialysis, Life Science Journal, 11 (1), p: 136 – 140.

    -        Riegel, B., Dickson, V., Cameron, J.,(2010), Symptoms Recognition in Elders with Heart Failure, Journal of  Nursing Scholarship, 42 (10), p: 92-105.[In Persian]

    -        Rifkin, D.E., Laws, M.B., Rao, M., Balakrishnan, V., Sarnak, M.J., Wilson, I.B., (2016), Medication Adherence Behavior and Priorities Among Older Adults with CKD: A Semi-strctured Interrview Study, American Journal of  Kidney Disease, 56 (3), p: 439 – 446.

    -        Rodriguez, Artalejo, F., Guallar, Castillon, P., Montoto, Otero,C, Conde, Herrera, M., Carreno, Ochoa, C., Tabuenca Martin, A.I., (2014), Self-care Behavior and  Patients’ Knowledge about Self-care Predict Re-hospitalization among Older Adults with Heart Failure, Revista Clinical Espanola, 6 (4), p: 269-275.

    -        Roger, V.L., Goas, Loyd-Jones, D.M., Benjamin, E.J., Berry, J.D., Borden, W.B., et al., (2016), Heart disease and Stroke statistics, American Heart Association Journal, 2 (2), p:125-147.

    -        Royani, Z., Rayyani, M., Vatanparast, M., Mahdavifar, M., Goleij, J., (2015), The Relationship between Self-care and Self-efficacy with Impowerment in Patients Understanding Hemodialysis, Military Caring Science, 1 (2), p: 116 – 122.

    -        Ruf, V., Sterwaet, S., Pretorius, S. Kubheka, M., Lautenshilager, C., Presek, P., Sliwa, K., (2017), Medication Adherence, Self-care Behavior and knowledge on Heart Failure Topics, Cardiovascular Journal of Africa, 21 (5), p: 86-92.

    -        Salehi, Z., Norouzi, Tabrizi, K., Hoseini, M., Sedghi, G.N., Soltani, P., (2017), Study of the Correlation between Medication Adherence and Quality of Life of Rheumatoid Arthritis Patients. Journal of Clinical Nursing and Midwifery, 6 (2), p: 1 – 13. [In Persian]

    -        Savadkoohi, k.,( 2012), A Survey of the Effect of Self – Management program on Self-Efficacy and Control of Disease in Hyper tensive patients, Jornal of Mazandaran University of Medical Science, 1 (1), p:23 -30.[In Persian]

    -        Schweitzer, R.D., Head, K., Dwyer, J.W., (2017), Psychological Factors and Treatment Adherence Behavior in Patients with Chronic Heart Failure, Journal of Cardiovascular Nursing, 4 (1), p: 76-83.

    -        Shively, M.J., (2010), Effect of Patient Activation on Self –management in Patients with Heart Failure, Journal of Cardiovascular Nursing,28 (1), p: 20 - 34

    -        Shojaei, F., Asemi, S., Najafi, y., Hossini, F., (2010), Self-care Behaviors in Patients with Heart Failure, Payesh Journal, 8 (4), p: 361-369.[In Persian]

    -        Siabani, S., Leeder, S.R., Davidson, P.M., Najafi, F., Hamzeh, B., et al. (2014), Traslation and Validation of the Self-care of Heart Failure Index, Hypertention Journal, 3 (7), p: 106-123. [In Persian]

    -        Smeulders, E.S., (2015), Nurse-led Self-management group Programe for Patients with Congestive Heart Failure: Randomized Controlled Trial, Journal of Advanced Nursing, 66 (7), p: 1487-99.

    -        Sol, B.G., Graaf, y.v., Peterson, R.V., Visseren, F.L., (2014), The Effect of Self-Efficacy on Cardiovascular Lifestyle, European Cardiovascular Journal, 10 (1), p: 1-7.

    -        Sol, B.G., Vander, B., Banga, J.D., Visseren, F.L.,(2015), Vascular Risk Management througt Nurse-led Self-Management programs, Vascular Nursing Journal, 23(1), P:20-24.

    -        Stromberg, A., Ahlen, H., Fridlund, B., Dahlstrom, U., (2014), Interactive Education on CD-ROM: A new Tool in the Education of Heart Failure Patients, Patient Education and Counseling, 46 (1), p: 75-81.     

    -        Thomas,C.M., (2017), The Influence of Self-Concept on Adherence to Recommended Health Regimens in Adults with Heart Failure, Journal of Cardiovascular Nursing, 22 (5), p: 405-416.                        

    -        Tung, H., Chen, S., Yin, W., Cheng, C., Wang, T., Wu, S.,(2012), Self-care Behavior in Patients with Heart Failure in Taiwan, European Journal of Cardiovascular Nursing, 11 (2), p: 175 – 182.

    -        Vahedian, A., Alhani, F., Ahmadi, F., Kazemnejad, A., (2015), Effect of Family Centered Empowerment model on the Life Style of Myocardial  Infarction Patients, Spacial Care Nursing Journal, 2 (4), p: 127-132.[In Persian]

    -        Vanderwal, M.H., Jaarsma, T., Moser, D.K., Vangilt, W. H., Vanveldhusen, D.J., (2012), Qualitative Examination of Compliance in Heart Failure patients in the Netherlands, Heart and Lung: The Journal of Acute and Critical Care, 39 (5), p: 121-130.

    -        Vanderwal, M.H., Jaarsma, T., Moser, D.K., Veeger, N.J., Vangilst, W.H., Vanveldhuisen, D.J., (2016), Compliance in Heart Failure Patients: The Importance of Knowledge and Beliefs, European Heart Journal, 27 (4), p: 434-440. 

    -        Vanderwal, M.H., Jaarsma, T., Vanveldhuisen, D. J., (2016), Non – Compliance in patients with Heart Failure: How we can manage it? European Journal of Heart Failure, 7 (1), p: 5-17.

    -        Wood, D.A., Kotseva, k., Connolly, S., Jennings, C., Mead, A., Jones, J., (2017), Nurse Coordinated Multidisciplinary: Family-based Cardiovascular Disease Prevention Program for Patient with Coronary Heart Disease and Asymptomatic Individuals at High Risk of Cardiovascular disease: A paired cluster randomized controlled trial, Lancet, 37(1), p:199-213.

    -        Wu, J.R., Moser, D.K., Chung, M.L., Lennie, T.A., (2018), Objectively Measured, but not Self-reported, Medication Adherence Independently Predicts Event-free Survival in Patients with Heart  Failure, Journal of Cardiac Failure, 14 (6), p: 203-210. 

    -        Zakeri, M.M., Ebrahimi, S., Shahsavari, H., Haghani, H.,(2017),  The Effect of Self - management Program after Discharging on Therapeutic Adherence in Patient with Ischemic Heart Disease, Iranian Journal of Nursing Research, 11 (1), p: 1712 -35. [In Peasian].