Application Of Symptom Management Education Based On IMB Model In Common Symptom Groups Of Patients With Chronic Heart Failure

Objective: The purpose of this study was to investigate the incidence and severity of symptoms in patients with chronic heart failure,and to identify the common symptom groups.Objective To explore the effects of symptom management education based on information-motivation-behavioral skill model(IMB)on common symptom groups,quality of life and symptom management self-efficacy in patients with chronic heart failure.Method: 1.A cross-sectional survey was conducted on 210 patients with chronic heart failure who received treatment in a third-grade Grade-A hospital in Xinjiang from December 2021 to March 2022 by convenience sampling method.The general situation Questionnaire,the Memorial Heart Failure Symptom Assessment Scale(MSAS-HF)and the Chinese version of the Minnesota Heart Failure Quality of Life Questionnaire(MLHFQ)were used as research tools.2.A total of 92 patients with chronic heart failure who received treatment in a third-grade grade-A hospital in Xinjiang from April 2022 to August 2022 were selected as the research objects.By the method of coin toss,two departments of the heart center were selected,one of which was the control group(n=46)and the other was the intervention group(n=46).The intervention group received symptom management education based on IMB model on the basis of routine health education.After 3 months of intervention,symptom severity,symptom management self-efficacy and quality of life scores in common symptom groups were compared.Results: 1.Cross-sectional survey Results:(1)210 patients with chronic heart failure had co-existing symptoms(10.44±3.93),and symptom burden score was(26.94±11.26).90.95% of patients had fatigue symptoms;92.86% of the patients had dyspnea of different severity,which was mainly manifested as shortness of breath after activities,dyspnea when lying flat,etc.88.57% of the patients had different forms of sleep disorders,mainly manifested as different degrees of sleep difficulties and awake at night sleep;In 80% of patients,fatigue,dyspnea of varying severity,and different forms of sleep disturbance occur at the same time as the disease progresses.In order of severity,they were shortness of breath(2.65±0.93)points,fatigue(2.53±0.95)points,sleep difficulty(2.50±1.13)points,wake up in night sleep(1.86±1.40)points,and dyspnea when lying flat(1.58±1.37)points.(2)The results of Pearson correlation analysis showed that the symptoms of shortness of breath,fatigue,sleep difficulty,and dyspnea during night sleep were significantly positively correlated with each other(P<0.05).The severity of each symptom was significantly correlated with the total score of quality of life(r=0.520～0.617)and the score of each dimension(r=0.520～0.643 in physical dimension,r=0.422～0.475 in emotional dimension,and r=0.467～0.556 in other dimensions)(P<0.05).(3)Hierarchical regression analysis showed that fatigue,dyspnea and sleep disorders had significant effects on quality of life(P<0.05),and could explain 35.9% of the variation in patients’ quality of life.2.Results of the intervention study:(1)Before intervention,there was no significant difference in the scores of general information,fatigue,dyspnea,sleep disorders,symptom management self-efficacy and quality of life between the two groups(P>0.05).(2)After intervention,symptom scores of fatigue,dyspnea and sleep disorder in the intervention group were lower than those in the control group,with statistical significance(P<0.05).(3)After intervention,symptom management self-efficacy scores in the intervention group were lower than those in the control group,and the difference was statistically significant(P<0.05).(4)After intervention,scores of body dimension,emotional dimension,other dimensions and quality of life in the intervention group were higher than those in the control group,with statistical significance(P<0.05).Conclusions: 1.Fatigue-dyspnea-sleep disorder symptom group is a common symptom group of patients with chronic heart failure,the incidence of symptoms within the group is higher,80% of patients with chronic heart failure in the process of disease progression will appear fatigue,breathing difficulties of different severity and different forms of sleep disorders.2.There was significant internal correlation among fatigue,dyspnea and sleep disorders;The severity of symptoms was positively correlated with the total score of quality of life and the scores of all dimensions,that is,the more severe the severity of fatigue,dyspnea and sleep disorder,the higher the score and total score of all dimensions of quality of life,the worse the quality of life.Quality of life scores were higher when all three symptoms occurred together than when a single symptom or two symptoms occurred together.3.Symptom management education based on IMB model has obvious intervention effect on common symptom groups of patients with chronic heart failure,which can alleviate the severity of symptom groups of patients with fatigue,dyspnea and sleep disorders,improve the self-efficacy of symptom management,and improve their quality of life and various dimensions.