家庭系统理论视角下慢性心力衰竭患者家庭照护的研究进展

doi:10.3761/j.issn.0254-1769.2023.13.020

摘要/Abstract

摘要：

随着生物-医学-社区医学模式的转变，越来越多的研究将慢性心力衰竭照护服务从医学视角转换到家庭视角，家庭系统理论对于慢性心力衰竭患者的家庭照护具有指导意义。该文综述了家庭系统理论及相关概念、慢性心力衰竭对家庭照护者的影响、慢性心力衰竭患者家庭照护关系的测量工具及干预策略，并对研究现状进行分析，提出建议，以期为实施慢性心力衰竭患者家庭照护干预提供理论依据。

关键词: 心力衰竭, 家庭系统理论, 家庭护理, 综述

Abstract:

With the transformation of the bio-medical-community medicine model，more studies change their research of heart failure care services from the medical perspective to the family perspective，and family system theory has guiding significance for family care for patients with chronic heart failure. This paper reviews the theory of family systems and the concept of family caregivers，the impact of chronic heart failure on family caregivers，measurement tools and interventions for family care relationships in patients with chronic heart failure，and puts forward the shortcomings and suggestions of the research status，in order to provide a theoretical basis for the research and development of family care for patients with chronic heart failure.

Key words: Heart Failure, Family System Theory, Family Nursing, Review

王雨晴, 张慧超, 孙绪晗, 吴媛, 王楠楠, 张玉玺. 家庭系统理论视角下慢性心力衰竭患者家庭照护的研究进展[J]. 中华护理杂志, 2023, 58(13): 1659-1664.

WANG Yuqing, ZHANG Huichao, SUN Xuhan, WU Yuan, WANG Nannan, ZHANG Yuxi. Research progress on family care in patients with chronic heart failure from the perspective of family system theory[J]. Chinese Journal of Nursing, 2023, 58(13): 1659-1664.

参考文献 38

[1]	中国老年医学学会心电及心功能分会, 中国医师协会心血管内科分会, 中国心衰中心联盟专家委员会. 慢性心力衰竭加重患者的综合管理中国专家共识2022[J]. 中国循环杂志, 2022, 37(3):215-225.
	Electrophysiology and Cardiac Function Branch of Chinese Society of Geriatrics, Cardiovascular Medicine Branch of Chi-nese Physicians Association, Expert Committee of China Heart Failure Center. Chinese expert consensus on comprehensive management of patients with worsening heart failure 2022[J]. Chin Circ J, 2022, 37(3):215-225.
[2]	Lovell J, Pham T, Noaman SQ, et al. Self-management of heart failure in dementia and cognitive impairment:a systematic review[J]. BMC Cardiovasc Disord, 2019, 19(1):99. DOI
[3]	Dokainish H, Teo K, Zhu J, et al. Global mortality variations in patients with heart failure:results from the International Congestive Heart Failure(INTER-CHF) prospective cohort study[J]. The Lancet Glob Health, 2017, 5(7):e665-e672. DOI URL
[4]	Grant JS, Graven LJ. Problems experienced by informal caregi-vers of individuals with heart failure:an integrative review[J]. Int J Nurs Stud, 2018, 80:41-66. DOI PMID
[5]	Bowen M. Family therapy in clinical practice[M]. New York: Jason Aronson, 1978:9-11.
[6]	Hsiao FH, Jow GM, Kuo WH, et al. The long-term effects of mindfulness added to family resilience-oriented couples support group on psychological well-being and cortisol responses in breast cancer survivors and their partners[J]. Mindfulness, 2016, 7(6):1365-1376. DOI URL
[7]	Sangly FE. Contemporary family sociology[M]. Tianjin: Tianjin People’s Publishing House, 2012:13-19.
[8]	任晓丽, 钟士恩, 黄佩红, 等. 基于家庭系统理论的亲子旅游动机测量研究:以南京市红山森林动物园为例[J]. 人文地理, 2019, 34(2):152-160.
	Ren XL, Zhong SE, Huang PH, et al. Measurement research of parent-child tourist motivations based on the theory of family system:an example of Nanjing Hongshan forest zoo[J]. Hum Geo-gr, 2019, 34(2):152-160.
[9]	Dirikkan F, Baysan Arabacı L, Mutlu E. The caregiver burden and the psychosocial adjustment of caregivers of cardiac failure patients[J]. Turk Kardiyol Dern Ars, 2018, 46(8):692-701. DOI PMID
[10]	杨盼盼, 范燕燕, 马梦真, 等. 慢性心力衰竭病人家庭照护者照护体验及需求研究现状[J]. 护理研究, 2021, 35(19):3469-3473.
	Yang PP, Fan YY, Ma MZ, et al. Research status quo of nursing experience and needs of family caregivers in patients with chronic heart failure[J]. Chin Nurs Res, 2021, 35(19):3469-3473.
[11]	Barello S, Castiglioni C, Bonanomi A, et al. The Caregiving Health Engagement Scale(CHE-s):development and initial validation of a new questionnaire for measuring family caregiver engage-ment in healthcare[J]. BMC Public Health, 2019, 19(1):1562. DOI PMID
[12]	吴玲玲, 高静, 顾静, 等. 家庭干预对肺癌患者照顾者照顾负担及生活质量的影响[J]. 上海护理, 2020, 20(9):42-45.
	Wu LL, Gao J, Gu J, et al. Effect of family intervention on caregiver burden and quality of life of lung cancer patients[J]. Shanghai Nurs, 2020, 20(9):42-45.
[13]	范文海, 刘悦, 李春霞, 等. 慢性心力衰竭患者照护者居家照护体验质性研究的Meta整合[J]. 中华护理杂志, 2022, 57(4):424-431. DOI URL
	Fan WH, Liu Y, Li CX, et al. The experience of informal caregivers caring for patients with chronic heart failure at home:a meta-synthesis of qualitative studies[J]. Chin J Nurs, 2022, 57(4):424-431.
[14]	Bidwell JT, Lyons KS, Lee CS. Caregiver well-being and patient outcomes in heart failure:a meta-analysis[J]. J Cardiovasc Nurs, 2017, 32(4):372-382. DOI PMID
[15]	Mccubbin HI, Thompson EA, Thompson AI, et al. “Family Sche-ma,paradigms,and paradigm shifts:components and processes of appraisal in family adaptation to crises” cognitive coping,families,and disability[M]. Baltimore,MD:Paul H. Brookes Pub-lishing, 1993,239-55.
[16]	刘英英, 刘晓堃, 韩全乐, 等. 心力衰竭患者配偶照顾者焦虑抑郁状况及其影响因素[J]. 职业与健康, 2017, 33(2):234-237.
	Liu YY, Liu XK, Han QL, et al. Anxiety and depression in spouse caregivers of heart failure patients and its influencing factors[J]. Occup Health, 2017, 33(2):234-237.
[17]	Barnes S, Whittingham K. Informal carers’ experiences of car-ing for a person with heart failure in a community setting[J]. Health Soc Care Community, 2020, 28(3):883-890. DOI URL
[18]	郭凤娟, 谢梦珂, 延明鑫, 等. 中青年慢性心力衰竭患者自我管理现状及其影响因素分析[J]. 解放军护理杂志, 2021, 38(6):5-8.
	Guo FJ, Xie MK, Yan MX, et al. Status quo of self-mana-gement in young and middle-aged patients with chronic heart failure and its influencing factors[J]. Nurs J Chin PLA, 2021, 38(6):5-8.
[19]	孙爱学. 未婚青年恶性肿瘤患者父母心理体验的质性研究[D]. 石家庄: 河北医科大学, 2015.
	Sun AX. A qualitative study on psychological experience of parents of unmarried young patients with malignant tumor[D]. Shijiazhuang: Hebei Medical University, 2015.
[20]	Olson DH, Sprenkle DH, Russell CS. Circumplex model of ma-rital and family system:I. Cohesion and adaptability dimen-sions,family types,and clinical applications[J]. Fam Process, 1979, 18(1):3-28. PMID
[21]	费立鹏, 沈其杰, 郑延平, 等. “家庭亲密度和适应性量表”和“家庭环境量表”的初步评价:正常家庭与精神分裂症家庭成员对照研究[J]. 中国心理卫生杂志, 1991, 5(5):198-202,238.
	Fei LP, Shen QJ, Zheng YP, et al. Preliminary evaluation of Chinese version of FACES Ⅱ and FES:comparison of normal families and families of schizophrenic patients[J]. Chin Ment Health J, 1991, 5(5):198-202,238
[22]	Smilkstein G, Ashworth C, Montano D. Validity and reliability of the family APGAR as a test of family function[J]. J Fam Pract, 1982, 15(2):303-311.
[23]	肖美丽, 刘丹, 杨东琪, 等. 家庭功能和孕期生活事件对孕晚期“二孩”孕妇的影响[J]. 中华护理杂志, 2019, 54(9):1354-1358. DOI URL
	Xiao ML, Liu D, Yang DQ, et al. Effect of family function and pregnancy life events on second child pregnant women in their third trimesters[J]. Chin J Nurs, 2019, 54(9):1354-1358. DOI URL
[24]	刘瑞, 杜敏霞, 李雪, 等. 家庭关怀度指数与D型人格对初中生逆反心理影响的路径分析[J]. 职业与健康, 2022, 38(15):2091-2094.
	Liu R, Du MX, Li X, et al. Path analysis on influence of family caring index and type D personality on reverse psychology of junior high school students[J]. Occup Health, 2022, 38(15):2091-2094.
[25]	Ritchie DP, State U. Family communication patterns:measuring intrapersonal perceptions of interpersonal relation-ships[J]. Com-munication Res, 1990, 17(4):523-544.
[26]	吴献. 家庭沟通媒介的使用对家庭沟通质量的影响研究[D]. 武汉: 华中科技大学, 2019.
	Wu X. Research on the influence of the use of family com-munication media on the quality of family communication in the era of Internet-taking college students in Wuhan as an example[D]. Wuhan: Huazhong University of Science and Tech-nology, 2019.
[27]	Weiss DS. The impact of event scale:revised[M]//Cross-Cul-tural Assessment of Psychological Trauma and PTSD. Boston, MA: Springer US, 2007:219-238.
[28]	郭素然, 辛自强, 耿柳娜. 事件影响量表修订版的信度和效度分析[J]. 中国临床心理学杂志, 2007, 15(1):15-17.
	Guo SR, Xin ZQ, Geng LN. Reliability and validity of Chinese version of the Impact of Event Scale-revised[J]. Chin J Clin Psychol, 2007, 15(1):15-17.
[29]	Astedt-Kurki P, Tarkka MT, Rikala MR, et al. Further testing of a family nursing instrument(FAFHES)[J]. Int J Nurs Stud, 2009, 46(3):350-359. DOI PMID
[30]	McCubbin HI, McCubbin MA. Typologies of resilient families:emerging roles of social class and ethnicity[J]. Fam Relat, 1988, 37(3):247. DOI URL
[31]	Piamjariyakul U, Smith CE, Russell C, et al. The feasibility of a telephone coaching program on heart failure home mana-gement for family caregivers[J]. Heart & Lung, 2013, 42(1):32-39.
[32]	柳琳升, 宋丹, 樊杰. 过渡期护理模式在慢性心衰患者家庭照顾者中的应用效果[J]. 世界最新医学信息文摘, 2019, 19(96):298-300.
	Liu LS, Song D, Fan J. Application effects of the transitional care model on chronic heart failure of family caregivers[J]. World Latest Med Inf, 2019, 19(96):298-300.
[33]	丁春戈, 梅永霞, 林蓓蕾, 等. 二元应对在慢性病患者及其配偶中的应用进展[J]. 中华护理杂志, 2018, 53(5):626-630.
	Ding CG, Mei YX, Lin BL, et al. The application of dyadic coping in patients with chronic diseases and their spouses[J]. Chin J Nurs, 2018, 53(5):626-630.
[34]	张贤贤, 张利霞, 贾智慧, 等. 夫妻自我表露在青年乳腺癌患者癌症复发恐惧干预中的应用研究[J]. 中华护理杂志, 2019, 54(11):1610-1614. DOI URL
	Zhang XX, Zhang LX, Jia ZH, et al. Application and effect evaluation of marital self-disclosure intervention on the fear of cancer recurrence in young breast cancer patients[J]. Chin J Nurs, 2019, 54(11):1610-1614. DOI URL
[35]	Liljeroos M, Ågren S, Jaarsma T, et al. Long term follow-up after a randomized integrated educational and psychosocial intervention in patient-partner dyads affected by heart failure[J]. PLoS One, 2015, 10(9):e0138058.
[36]	Falconier MK, Jackson JB, Hilpert P, et al. Dyadic coping and relationship satisfaction:a meta-analysis[J]. Clin Psychol Rev, 2015, 42:28-46. DOI PMID
[37]	李明士, 邓小岚, 葛兆霞. 164例老年痴呆患者主要照顾者哀伤现状及影响因素分析[J]. 护理学报, 2021, 28(2):52-57.
	Li MS, Deng XL, Ge ZX. Current status of grief of primary caregivers of dementia patients and its influence factors:a 164-case study[J]. J Nurs China, 2021, 28(2):52-57.
[38]	潘小容, 莫霖, 刘倩, 等. 家庭正向行为支持方案的构建及应用研究[J]. 中华护理杂志, 2021, 56(11):1618-1626. DOI URL
	Pan XR, Mo L, Liu Q, et al. Construction and application of family-positive behavior support programme for preschool children with malignant tumors[J]. Chin J Nurs, 2021, 56(11):1618-1626. DOI URL