慢性心力衰竭患者家庭照顾者照护技能干预方案的构建及应用研究

doi:10.3761/j.issn.0254-1769.2026.06.008

摘要/Abstract

摘要：

目的构建基于赋权理论的医院-社区-家庭三元联动慢性心力衰竭患者家庭照顾者照护技能干预方案并验证其应用效果。方法通过文献检索、专家函询、预试验等形成该方案。选择2023年8月至2024年2月在徐州市某三级甲等医院心内科住院且居住在与医院有合作关系的3个社区卫生服务中心服务范围内的90对慢性心力衰竭患者及其家庭照顾者作为研究对象。为防止组间沾染，选择有空间距离的2个病区，采用抛硬币方法，将2个病区随机分为试验组和对照组，每组各45对。试验组在常规健康指导基础上实施该方案，对照组给予常规健康指导，两组均干预12个月。比较两组干预前后家庭照顾者在照顾能力、照顾负担及患者生活质量方面的差异。结果共84对患者及其家庭照顾者完成干预，试验组和对照组各42对。重复测量方差分析显示，两组家庭照顾者照顾能力、照顾负担和患者生活质量均存在组间和时间的交互效应（P<0.001）。简单效应分析结果表明，干预3、6、9、12个月后，试验组家庭照顾者照顾能力、照顾负担评分低于对照组，试验组患者生活质量评分高于对照组（P<0.05）。结论实施该方案不仅能增强照顾者的照顾能力，减轻其照顾负担，还能提升患者的生活质量。

关键词: 赋权理论, 慢性心力衰竭, 家庭照顾者, 照顾能力, 照顾负担, 生活质量, 护理

Abstract:

Objective This study aims to develop an intervention program to enhance the caregiving skills of family caregivers of patients with chronic heart failure，grounded in empowerment theory and incorporating a triadic collaboration among hospital，community，and family. Additionally，the study seeks to evaluate the effectiveness of the program. Methods The intervention program was designed through a comprehensive literature review，expert consultations，and pilot testing. The study involved 90 matched pairs of patients with chronic heart failure，who were admitted to the cardiology department of a tertiary hospital in Xuzhou between August 2023 and February 2024，and who resided within the service areas of 3 affiliated community health centers. 2 spatially separated cardiology wards were randomly assigned via coin toss to either an experimental group or a control group，each comprising 45 pairs. The experimental group received the intervention program alongside routine health guidance，while the control group received only routine health guidance. Both groups were monitored over a 12-month period. The study compared differences in caregivers’ caregiving abilities and burdens，as well as patients’ quality of life，before and after the intervention. Results A total of 84 dyads completed the intervention，with 42 dyads allocated to each group. A repeated measures ANOVA demonstrated significant main effects of group and time，as well as a significant interaction effect on caregivers’ caregiving ability and burden，in addition to patients’ quality of life（P<0.001）. Subsequent simple effects analysis revealed that at 3-，6-，9-，and 12-months post-intervention，the experimental group exhibited significantly lower scores in caregiving ability，lower scores in caregiving burden，and higher patient quality of life compared to the control group（P<0.05）. Conclusion The implementation of this program can effectively enhance caregivers’ caregiving skills，alleviate their caregiving burden，and improve patients’ quality of life.

Key words: Empowerment Theory, Chronic Heart Failure, Family Caregivers, Caring Ability, Care Burden, Quality of Life, Nursing Care

赵浩, 赵颖, 杨艳珍. 慢性心力衰竭患者家庭照顾者照护技能干预方案的构建及应用研究[J]. 中华护理杂志, 2026, 61(6): 775-782.

ZHAO Hao, ZHAO Ying, YANG Yanzhen. A study on creating and implementing a caregiving skills program for family caregivers of chronic heart failure patients[J]. Chinese Journal of Nursing, 2026, 61(6): 775-782.

图/表 6

表1 慢性心力衰竭患者家庭照顾者照护技能干预方案

Table 1 Care skills intervention program for family caregivers of patients with chronic heart failure

表2 两组患者一般资料的比较[例（百分比,%）]

Table 2 Comparison of general characteristics between 2 groups of patients[cases（percentage,%）]

表3 两组家庭照顾者一般资料的比较[名（百分比,%）]

Table 3 Comparison of general characteristics between 2 groups of family caregivers[cases（percentage,%）]

表4 两组家庭照顾者照顾能力量表评分的比较（分,$\bar{x} \pm s$）

Table 4 Comparison of caregiver competency scale scores between 2 groups of family caregivers（score，$\bar{x} \pm s$）

表5 两组家庭照顾者负担量表评分的比较（分, $\bar{x} \pm s$）

Table 5 Comparison of family caregiver burden scale scores between 2 groups （score, $\bar{x} \pm s$）

表6 两组患者生活质量量表评分的比较（分, $\bar{x} \pm s$）

Table 6 Comparison of Quality of Life Scale Scores between 2 patient groups（score，$\bar{x} \pm s$）

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