心臟衰竭再同步治療患者術後生活品質與心理行為因素相關性之探討

The Relationship Between Quality of Life and Psychological and Behavioral Factors in Patients With Heart Failure Following Cardiac Resynchronization Therapy

背景：心臟再同步治療能提高心臟衰竭患者生活品質，但患者術後生活品質常受到各種心理行為因素的影響。然而目前缺乏討論再同步治療術後患者生活品質與患者心理行為因素的相關性研究。目的：探究心臟衰竭再同步治療患者術後生活品質與憂鬱狀況、吸菸、飲酒、限制液體攝入、限制鈉攝入、運動及醫囑遵從等心理行為因素的相關性。方法：採橫斷性研究、方便抽樣選取成都市某三甲醫院接受心臟再同步治療的141名患者為研究對象，以Morisky服藥依從性問卷、心臟病患者憂鬱調查表和明尼蘇達心臟衰竭生活品質量表為研究工具。結果：患者在生活品質總得分為30.89（滿分為105）。而限制液體攝入、憂鬱狀態及規律運動為生活品質總得分和情緒領域之重要預測因數，限制鈉攝入及規律運動為生活品質身體領域之重要預測因數。結論：實務應用本研究結果可幫助護理人員瞭解心臟再同步治療術後患者之生活品質，了解生活品質與患者心理行為因素的相關性，研究結果期為護理人員指導和管理患者術後健康行為之未來參考依據。

Background: While cardiac resynchronization therapy improves the quality of life of patients with heart failure, some psychological and behavioral factors still affect the quality of life of these patients. However, information on the factors that affect the quality of life of these patients is limited. Purpose: To describe the quality of life and investigate the relationship between quality of life and behavioral and psychological factors such as depression, smoking, drinking, water and sodium restrictions, exercise, and adherence in patients with chronic heart failure following cardiac resynchronization therapy. Methods: This cross-sectional study was conducted using the Morisky Medication Adherence Scale, Minnesota Living With Heart Failure Questionnaire, and Cardiac Depression Scale. A convenience sample of 141 patients with heart failure following cardiac resynchronization therapy were recruited from a tertiary academic hospital in Chengdu. Results: The mean overall score of the Minnesota Living With Heart Failure Questionnaire was 30.89 (out of a total possible score of 105). Water restrictions, sodium restrictions, depression, and exercise were all shown to significantly predict quality of life among the participants. Conclusion/Implications for Practice: This paper describes the quality of life and defines the behavioral factors that affect the quality of life of patients with heart failure following cardiac resynchronization therapy. The findings suggest that nurses should manage and conduct health education for patients in order to improve their quality of life.