同伴支持在慢性心力衰竭患者自我護理的應用研究

Abstract

Chronicheartfailureisamedicalconditionthatcanhaveasignificantimpactonthequalityoflifeforthoseaffectedbyit.Managingchronicheartfailurerequiresacombinationofmedication,lifestylechanges,andself-carebehaviors.However,individualpatientsmayhavedifficultyadheringtothesebehaviors,andresearchhasshownthattheinvolvementofsocialsupport,suchasfamilyandfriends,canhelptoimprovepatientoutcomes.Inthispaper,wewilldiscusstheapplicationofpeersupportintheself-careofchronicheartfailurepatients,itsbenefitsandchallenges,andstrategiestoenhanceitseffectiveness.

Introduction

Chronicheartfailure(CHF)isaprogressivemedicalconditioncharacterizedbytheinabilityofthehearttoadequatelypumpbloodthroughoutthebody.CHFaffectsanestimated26millionpeopleworldwideandisaleadingcauseofhospitalizationandmortality.ThemanagementofCHFrequiresacombinationofmedication,lifestylechanges,andself-carebehaviorssuchasmonitoringsymptoms,adheringtomedicationschedules,andfollowingalow-sodiumdiet.However,patientswithCHFmayhavedifficultyadheringtoself-managementbehaviors,whichcanleadtoworseningsymptomsandincreasedhospitalizations.

Peersupport,definedassupportprovidedbyindividualswhohavesimilarexperiencesorwhosharesimilarlifestyles,hasshowngreatpromiseinimprovingpatientoutcomesinavarietyofchronicconditions.InthecontextofCHF,peersupporthasbeenusedtoimprovepatientadherencetoself-carebehaviorsandreducehospitalizations.Inthispaper,wewillexploretheapplicationofpeersupportinCHFself-care,itsbenefitsandchallenges,andstrategiestoenhanceitseffectiveness.

BenefitsofPeerSupportinCHFSelf-Care

MultiplestudieshavedemonstratedthebenefitsofpeersupportinCHFself-care.InarandomizedcontrolledtrialbyBucketal.,patientswithCHFwhoreceivedpeersupportviamonthlytelephonecallsfromtrainedpeersupportersforsixmonthshadfewerhospitalizationsandemergencyroomvisitsthanthosewhoreceivedstandardcare.Similarly,inastudybyClarketal.,patientswithCHFwhoreceivedpeersupportfromacommunitygrouphadsignificantlybetteradherencetomedicationschedules,lowerbodymassindex,andfewerhospitaladmissionsthanthosewhodidnotreceivepeersupport.

Peersupportcanalsocontributetoimprovedpatientself-efficacy,oranindividual'sconfidenceintheirabilitytomanagetheirhealth.AstudybyGallagheretal.foundthatpatientswithCHFwhoreceivedpeersupportreportedgreaterconfidenceintheirabilitytomanagetheirsymptomsandadheretotheirmedicationschedulesthanthosewhodidnotreceivepeersupport.

ChallengesinImplementingPeerSupportinCHFSelf-Care

DespitethepromisingbenefitsofpeersupportinCHFself-care,thereareseveralchallengestoimplementingthisapproach.Onechallengeisidentifyingandrecruitingappropriatepeersupporters.PeersupportersshouldbeindividualswhohaveexperiencewithCHFanditsself-managementbehaviorsandwhoarewillingandabletoprovideongoingsupporttopatients.Thiscanbechallenging,asnotallpatientswithCHFhaveaccesstosupportivepeers,andsomemaynotfeelcomfortabledivulgingpersonalhealthinformationtopeers.

Anotherchallengeisensuringthequalityandconsistencyofpeersupport.PeersupportersshouldbeadequatelytrainedinCHFself-managementbehaviors,communicationskills,andconfidentiality.Additionally,peersupportersshouldbeprovidedwithongoingsupportandsupervisiontoensurethattheyareimplementingeffectivestrategiesandadheringtobestpractices.

StrategiestoEnhancetheEffectivenessofPeerSupportinCHFSelf-Care

ToenhancetheeffectivenessofpeersupportinCHFself-care,severalstrategiescanbeimplemented.Onestrategyistoprovidepeersupporterswithongoingtrainingandsupport.Thiscanincluderegularmeetingswithasupervisorormentor,continuingeducationonCHFself-managementbehaviors,andopportunitiesforpeersupporterstosharetheirexperiencesandlearnfromoneanother.

Anotherstrategyistousetechnologytofacilitatepeersupport.Thiscanincludevirtualsupportgroups,onlineforums,andmobileappsthatallowpatientstoconnectwithpeersupportersandreceivesupportandencouragementinreal-time.Technologycanalsobeusedtotrackpatientadherencetoself-managementbehaviorsandprovidefeedbacktobothpatientsandpeersupporters.

Conclusion

PeersupporthasshowngreatpromiseinimprovingpatientoutcomesinCHFself-care.Byprovidingpatientswithsocialsupportandencouragementintheirself-managementbehaviors,peersupportcancontributetoimprovedadherencetomedicationschedules,reducedhospitalizations,andincreasedpatientself-efficacy.However,theimplementationofpeersupportinCHFself-carecanbechallenging,requiringcarefulidentificationandtrainingofappropriatepee