自我管理計畫對心臟衰竭老人成效之探討

The Effectiveness of Self-management Programs for Elderly People with Heart Failure

心臟衰竭為全球性健康問題，有極高死亡率及罹病率。由於心臟衰竭常會合併水分及鈉滯留，因此經由自我管理計畫提升個案飲食自我效能、增加照顧能力，進而將改變其健康行為。本研究探討自我管理計畫對改善心臟衰竭老人飲食控制成效，透過實驗性研究設計，選取醫學中心93位心臟衰竭老人，經隨機分配至實驗組及控制組，實驗組個案接受自我管理計畫，著重於飲食中鈉、水分及體重的自我監測，以增進飲食控制的自我效能，兩組個案於收案一個月後收集自我效能、體重及再入院率。研究結果發現實驗組飲食控制較控制組好，顯示自我效能對心臟衰竭老人有幫助，但體重和再入院率則無顯著差異。

Heart failure (HF) is a major public health problem around the world, with mortality and morbidity rates remaining high. It is greatly influenced by sodium and fluid retention and so the program proposed in this analysis was to provide dietary control that enhances self-efficacy as a means to bring about a change in health. This experimental design was used to examine the effectiveness of self-management (SM) intervention for elderly patients with HF. A total of 93 subjects from a hospital were randomly assigned to the SM and control groups. This program emphasized self-monitoring of each patients diet, specifically focusing on sodium and fluid restrictions as well as body weight. Data for the outcome of self-efficacy for dietary control, body weight and rate of readmission were collected at baseline and week four. Although the results indicated that there was a difference in dietary self-efficacy between the two groups, there was no significant difference between two groups in terms of body weight and rate of readmission.