Aplicación de la escala europea de autocuidado en insuficiencia cardíaca (EHFScBS) en una unidad de insuficiencia cardíaca en España

Unidad de Insuficiencia Cardíaca. Hospital Universitari Germans Trias i Pujol. Badalona. Barcelona. España
Revista Espa de Cardiologia (Impact Factor: 3.34). 02/2006; DOI: 10.1157/13084645
Source: OAI

ABSTRACT El autocuidado es importante para los pacientes con insuficiencia cardíaca. La European Heart Failure Self-care Behaviour Scale o escala europea de autocuidado en insuficiencia cardíaca ha sido recientemente desarrollada para evaluar el autocuidado de los pacientes. Evaluamos a 335 pacientes con la versión española de la escala y analizamos si el autocuidado se relacionaba con la edad, el sexo, la etiología y el tiempo de seguimiento en la unidad. La puntuación en la escala es de 12 a 60, y los valores inferiores son los que indican un mejor autocuidado. La media de la puntuación obtenida fue de 24,2 ± 7,7. No hubo correlación estadística entre los resultados y los parámetros analizados, excepto para el tiempo de seguimiento en la unidad (r = ­0,37; p < 0,001). La puntuación fue 28,1 ± 1,9 en los pacientes evaluados en la primera visita; 23,1 ± 6,1 a los 3 meses; 24,1 ± 6,6 a los 6 meses; 23,3 ± 8,2 a los 9 meses; 22,8 ± 7,3 a los 12 meses y, finalmente, 20,0 ± 5,5 en los pacientes evaluados 15 meses después de la primera visita en la unidad.

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    ABSTRACT: Introduction This study examined the association of self-care behavior and patients’ knowledge about self-care with rehospitalization among older adults with heart failure (HF). Methods Case-control comparison (116 cases and 209 controls) nested in a prospective cohort of patients aged 65 years and older admitted for HF at 4 Spanish hospitals. Cases were patients experiencing a first emergency rehospitalization in the 6 months following the index hospital admission. Controls were patients who did not undergo a rehospitalization during such time-period. Results The number of self-care behaviors was inversely associated with the frequency of readmission (p for linear trend: 0.006). Compared with patients showing the appropriate self-care behavior, hospital readmission was more frequent among those who did no go for a walk daily or did not engage in any daily physical activity (hazard ratio [HR] 1.55; 95% confidence limits [CL] 1.04-2.29), and among those who did not keep their medical appointments (HR 1.82; 95% CL 1.10-3.02). Hospital readmission was also more frequent among patients who: failed to take their medication at the scheduled time (HR 2.07; 95% CL 1.15-3.72); stopped taking their medication when it disagreed with them (HR 1.76; 95% CL 1.08-2.85); and failed to adhere to their drug treatment (HR 1.96; 95% CL 1.29-2.98). Furthermore, the fewer the number of behaviors which patients knew to be required for self-care, the greater the frequency of rehospitalization (p for linear trend:0.029). Conclusions A lower degree of self-care and of patients’ knowledge about self-care predicted a higher risk of hospital readmission.
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