关键词: 心力衰竭, 自我管理, 生活质量, 延续护理

Abstract:

Objective To develop and explore the application effect of the self-management decision wheel in patients with chronic heart failure（CHF）. Methods Based on literature review and patient interviews，a self-management decision wheel for CHF patients at all levels of knowledge was developed. Patients with CHF who were admitted to a tertiary A hospital in Zhejiang province from July 2021 to June 2022 were selected as the research subjects，among which 80 patients from January to June 2022 were taken as the intervention group，and 85 patients from July to December 2021 were selected as the control group. The intervention group used the decision wheel for self-management on the basis of the traditional management，and the control group was managed according to the traditional method. Self-care ability，carbon dioxide ventilation equivalent slope（VE/VCO₂ slope），major adverse cardiac events，and re-hospitalization rates were compared at 1th and 3th after intervention between the 2 groups. Results A total of 3 cases were dropped，and 78 cases in the final experimental group and 84 cases in the control group. The results of repeated measurement analysis of variance showed that at different time points the self-care ability， time effect of VE/VCO₂ slope，inter group effect，and interaction effect of the two groups were statistically significant（P<0.05），and the experimental group was superior to the control group. The incidence of cardiovascular adverse events and the re-hospitalization rate in the experimental group were lower than those in the control group at 3 months（P<0.001）. Conclusion The self-management decision tool constructed in this study is more scientific and practical，and it can effectively improve the self-care ability of patients with CHF，improve the patient prognosis，and reduce the rate of re-hospitalization.

Key words: Heart Failure, Self-Management, Quality of Life, Continuing Nursing