| 摘要: | 研究背景：心臟衰竭是心血管疾病的末期臨床表徵。初期症狀輕微，但隨著時間推移而逐漸惡化，除了症狀控制的藥物之外，若能有好的日常生活照護，可延緩心臟衰竭惡化，減少併發症的發生，提升生活品質。
研究目的：探討ADHF病人居家水份控制之生活經驗。
研究方法：本研究採質性研究設計，以半結構式問卷做深度訪談，資料收集自2023年4月到2024年2月，針對台北市某醫學中心心臟內外科病房進行收案，透過內容分析法，加以歸納並分析出急性失代償性心臟衰竭病患人控制水份滯留之經驗。
研究結果：本研究共訪談14位因急性失代償性心臟衰竭入院的病人，統整出八大項水份控制議題：(一)以固定容器來限定每日進水量、(二)盡量克制，透過一些方法降低每次進水量、(三)均分每日可進水的總量、(四)尋找水以外的替代品、(五)盡量降低鹽分的攝取、(六)飲食中鹽分的含量很難由自己控制、(七)根據自我感覺來評估尿量多寡、(八)以測量體重取代水份攝取的限制。
結論：急性失代償性心臟衰竭病人透過多方面來控制水份滯留，在水份攝取控制方面：雖然採取多項限水措施，但因限水造成的口渴感受，直接影響病人遵循水份控制，若能改善口渴症狀，能增加病人對限水的遵從性；鹽分攝取方面：雖然會盡量降低鹽分的攝取，但因外食多，鹽分的含量很難由自己控制，建議可採健康飲食、教育低鹽飲食的攝取、學習認識食物標示、檢測食物的鹽分含量；自我監測方面：尿量監控、每日測量體重是最常採用的方式。本研究顯示病人在疾病識能和自我照顧上存在不足的地方，需要護理人員提供進一步的衛教來強化水份滯留的控制，同時需要家人的支持和協助，來改善飲食和生活習慣，才能更穩定的控制疾病，避免快速惡化。
Background: Heart failure represents the end-stage clinical manifestation of cardiovascular disease. Initial symptoms are mild but progressively worsen over time. Besides symptom-controlling drugs, good daily care can delay the worsening of heart failure, reduce the occurrence of complications, and enhance the quality of life.
Objective: This study aims to explore the life experiences of Acute Decompensated Heart Failure (ADHF) patients with home hydration control.
Methods: A qualitative research design was adopted for this study, utilizing semi-structured questionnaires for in-depth interviews. Data were collected from April 2023 to February 2024. Cases were sourced from the cardiac surgery ward of a medical center in Taipei City. The experiences of ADHF patients in controlling water retention were summarized and analyzed through content analysis methods.
Result: The study conducted interviews with 14 patients hospitalized for ADHF and identified eight major themes related to water control: (1) Using fixed containers to limit daily water intake, (2) Exercising restraint and employing methods to reduce water intake each time, (3) Dividing the total daily water allowance equally, (4) Seeking alternatives to water, (5) Attempting to minimize salt intake, (6) Struggling with self-control of dietary salt content, (7) Evaluating urine output based on personal feelings, (8) Measuring body weight as an alternative to limiting water intake.
Conclusion: Patients with ADHF manage water retention through various strategies. In terms of water intake control, despite numerous water restriction measures, the thirst induced by water restriction directly impacts patient compliance. If thirst symptoms can be alleviated, patient compliance with water restriction may improve. Regarding salt intake, although patients attempt to minimize salt intake, self-control of dietary salt content is challenging due to the prevalence of outside food. It is recommended to adopt a healthy diet, educate on low-salt diet intake, learn to understand food labels, and detect the salt content of food. Self-monitoring methods such as urine output monitoring and daily weight measurement are commonly used.
This study reveals that patients have deficiencies in disease awareness and self-care. Nursing staff need to provide further education to strengthen water retention control. Simultaneously, support and assistance from family members are needed to improve dietary and lifestyle habits, thereby achieving more stable disease control and preventing rapid deterioration. |
