应用 Rodgers 演化概念分析法界定慢性心力衰竭患者的自我管理

摘要

Objective To clarify the concept of self-management in the context of heart failure based on Rodgers' evolutionary concept analysis. Methods Thirty-six references were recruited through the databases of PubMed, CINAL, PsycINFO and Wanfang database. The evolution of the concept of self-management, its attributes, antecedents, consequences, related concepts and measurement were analyzed and combined. Results The self-management in heart failure patients involved a cont inuous self-regulation process and the conceptual attributes were composed of five aspects: disease knowledge, support-seeking, self-efficacy,activities and self-perception. The antecedents of self-management included personal factors and environmental resources. Re-hospitalization rate,mortality rate,medical charge,quality of life and self-management were the consequences observed. Conclusions The novel concept extracted from the present work can be applied as the basis for nursing care support to strengthen the level of self-management in heart failure patients. Developing a valid instrument to measure self-management of heart failure patients is suggested.%目的 运用Rodgers演化概念分析法界定慢性心力衰竭患者自我管理的概念.方法 系统检索Pubmed、CINAL、PsycINFO和万方数据知识服务平台,根据有关标准纳入了36篇文献进行概念分析,从概念的演变史、定义性特征、先决条件、结局、同义词与近义词、测评指标等方面,对当前慢性心力衰竭自我管理的概念进行了分析.结果 慢性心力衰竭患者自我管理涉及一个递进的自我调节过程,包括5个定义性特征:疾病知识、寻求支持、自我效能、行为表现和自我感知.其先决条件包括个体因素和环境资源,结局关注再住院率(病死率)、医疗费用、生活质量和自我管理.结论 澄清慢性心衰患者自我管理概念有助于临床开发慢性心力衰竭自我管理支持项目,编制有效评价慢性心衰患者自我管理的测评工具是未来的研究方向之一.