CAJ | 학술논문

目的：探讨慢性心功能衰竭患者认知功能对自我护理的影响，识别认知受损的患者，以期引起护理人员对慢性心功能衰竭患者认知功能的关注，为优先对认知受损患者提供实施延续性护理服务提供依据。方法对北京阜外心血管病医院慢性心功能衰竭监护病房及内科重症监护病房的152例住院慢性心功能衰竭患者，使用蒙特利尔认知功能评估表和心功能衰竭自我护理指数量表进行调查。结果以24分为界值，发现21.3%的患者伴认知功能损伤；其中延迟回忆、语言、视空间与执行功能维度受损较严重；多元线性回归分析结果显示，年龄、心功能分级、抑郁状况及认知功能对自我护理维持变异的解释度为30.1%，其中认知功能占21.5%；认知功能对自我护理管理及自我护理信心变异的解释度分别为29.2%和36.5%。结论慢性心功能衰竭患者的认知功能影响了其自我护理，医务人员在临床工作中应识别认知受损的慢性心功能衰竭患者并对其优先实施延续性护理。
목적：탐토만성심공능쇠갈환자인지공능대자아호리적영향，식별인지수손적환자，이기인기호리인원대만성심공능쇠갈환자인지공능적관주，위우선대인지수손환자제공실시연속성호리복무제공의거。방법대북경부외심혈관병의원만성심공능쇠갈감호병방급내과중증감호병방적152례주원만성심공능쇠갈환자，사용몽특리이인지공능평고표화심공능쇠갈자아호리지수량표진행조사。결과이24분위계치，발현21.3%적환자반인지공능손상；기중연지회억、어언、시공간여집행공능유도수손교엄중；다원선성회귀분석결과현시，년령、심공능분급、억욱상황급인지공능대자아호리유지변이적해석도위30.1%，기중인지공능점21.5%；인지공능대자아호리관리급자아호리신심변이적해석도분별위29.2%화36.5%。결론만성심공능쇠갈환자적인지공능영향료기자아호리，의무인원재림상공작중응식별인지수손적만성심공능쇠갈환자병대기우선실시연속성호리。
Objective To explore the influence of cognitive function on self-care in patients with chronic heart failure, to screen out patients with cognitive impairment and to provide priority for them in continuous care service. Methods With a cross-sectional study, patients with heart failure (n=152) were recruited from Heart Failure Care Unit and Intensive Care Unit of a hospital specialized in cardiovascular disease in Beijing. The cognitive function and the level of self-care were measured through the Montreal Cognitive Assessment and Self-Care in Heart Failure Index. Results The Montreal Cognitive Assessment score showed that 21.3%of the patients (scored <24) suffered from cognitive impairment and their delayed memory, langue, visual spatial and executive capability were impaired most seriously. Multiple regression analysis indicated that age, New York Heart Association Class, depression a nd cognitive function accounted for 30.1% of the total variance in self-care maintenance; the Montreal Cognitive Assessment score explained 21.5%, 29.2% and 36.5% of the variance in self-care maintenance, management and confidence respectively. Conclusion Cognitive impairment, a hidden co-morbidity, may impede patients ’ ability of self-care. The patients with cognitive impairment should be screened out and provided with priority in continuous care service.