| Summary: | 碩士 === 國立陽明大學 === 臨床暨社區護理研究所 === 101 === Abstract
The purpose of this study was to investigate the effect of supportive nursing care program on fatigue and quality of life of patient with heart failure. This study was an experimental design. We recruited 92 patients from cardiovascular outpatient department and ward (patients who were going to discharge) in a medical center of the Taichung City of Taiwan. These patients were assigned randomly to experimental group (n = 47) and control group (n = 45). Patients in the experimental group received supportive nursing care program for 12 weeks while those in the control group received regular nursing care. To understand the effect of supportive nursing care, the data was measured repeatedly. Participants completed structural questionnaire in pre-test, fourth, 8th and 12th weeks after intervention. The instruments included basic data, Piper Fatigue Scale, Symptom Distress Scale, Minnesota Heart failure Questionnaire, Hospital Anxiety and Depression Scale and Social Support Scale. Data was analyzed by percentage, mean , standard deviation, chi-square, Pearson’s independent t-test, one way ANONA and generalized estimating equation (GEE).
The results showed as following: (1) 70% patients had mild to moderate fatigue；(2) Fatigue in all heart failure patients showed significant correlation to NYHA classification, OPD/ admission, sleep time, symptoms distress, mental distress, and social support；(3) The quality of life of heart failure patient was very slightly to slightly affected by the disease. The physical quality of life was the worst part of it；(4) The quality of life in all patients were significant correlated to marriage, sleep time, NYHA classification, OPD/admission, fatigue, symptom distress, usage of calcium channel blocker, mental distress, and social support；(5) In the experimental group, the score of fatigue decreased more in pre-test to the fourth week post intervention than in the 8th and the 12th weeks(F = 7.425, P ＜ .001). In the control group, the score of fatigue showed no significant differences between pre-intervention and post-intervention. After intervention for 12 weeks, the improvement of fatigue was better in experimental group than in control group, significantly (β = -5.32, P ＜ .01)；(6) In the experimental group, after 12 weeks of supportive nursing care program intervention, there were significant improvements in overall, physical, emotional, and general quality of life (P ＜ .001). In the control group, overall, physical, and general quality of life improved significantly after intervention but not as much as in the experimental group. And the experimental group improved more significantly in overall quality of life (β = -9.44, P ＜ .05) and emotional quality of life (β = -3.745, P ＜. 01) in the 12th weeks after intervention than the control group.
The research proved supportive nursing care program can effectively improve the fatigue and quality of life in heart failure patients. The intervention program was non-invasive, safe and effective supportive care. We suggested that the program could be applied to other heart failure patients in the future and expanded it to outpatient department, to improve their fatigue and quality of life.
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