关键词: 老年； 慢性心力衰竭； 容量管理；自我管理；计划行为理论；方案构建

Abstract: Objective: To construct a self-volume management program in elderly patients with chronic heart failure and and evaluate its application effectiveness, so as to improve their self-care ability. Methods: Based on the Theory of Planned Behavior, the program of self-volume management for elderly patients with chronic heart failure was constructed with Delphi method, including behavioral attitude, subjective norms, perceived behavioral control, behavioral intention to generation. Elderly patients with chronic heart failure admitted to a tertiary grade A hospital in Beijing from June 2022 to January 2023 was selected by convenient sampling. Those were admitted from June to September 2022 were set as the control group (n=47), and they were with routine nursing care. Those were admitted from October 2022 to January 2023 were set as the intervention group (n=44), and they were with routine nursing care combined with self-volume management. Self-care ability, volume-related indicators, and the incidence of adverse cardiovascular events were compared between the two groups after 3 months. Results: After 3 months, the self-care ability score of the patients in intervention group was lower than that of the control group (P<0.001), and the decrease in brain natriuretic peptide levels and weight loss was greater than that of the control group (P<0.001). The left ventricular end diastolic diameter of the the patients in intervention group decreased, while the control group expanded, the trend of changes in the two groups was statistically different (P=0.036). There was no statistically significant difference in the incidence of cardiovascular adverse events between the two groups (P=0.138). Conclusion: The self-volume management programs constructed in this study are benefit to improve the self-management ability and volume management effects of elderly patients with chronic heart failure, and can provide a reference for self-volume management in this population.

Key words: elderly; chronic heart failure; volume management; self management; Theory of Planned Behavior; program construction