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目的调查我国成都地区社区目前心衰患者家庭支持的现状,以便提出更为行之有效的心衰患者干预模式。方法 2009年5月～12月,以成都市青羊区苏坡社区和周边新都区城东社区两个区域作为调查基地,采用整群抽样方法对其中12个自然居民小区165例New York心功能分级Ⅱ～Ⅳ级心力衰竭患者通过问卷调查方式进行横断面基线调查(新都城东社区85例患者,苏坡社区80例)。结果心衰患者家庭组成结构(独居/孤寡心衰患者8.5%;丧偶或离异与子女或保姆同住患者17%;家庭健全与配偶及/或子女同住患者74.5%),家属参与管理人员构成权重(配偶60.4%;子女32.9%;亲戚、朋友、保姆、看护人员或自己照顾自己6.7%),家属参与管理程度(全面管理患者家庭治疗11.2%,偶尔参与患者家庭治疗50.3%,完全不参与患者家庭治疗38.5%),患者对家庭支持的需求(很需要10.9%,需要25.5%,不需要62.4%,坚决不要1.2%),患者年龄及疾病程度与其对家属支持的需求有一定相关性。结论配偶是成都地区社区心衰患者疾病管理最主要的家庭支持者,其次为子女。成都地区社区大部分心衰患者缺乏有效家庭支持,而大部分患者亦认为自身疾病不需要家庭支持。老年高龄、心衰症状重患者对于家属支持的需求迫切。独居患者的家庭支持问题在高龄患者中尤为突出。社区心衰患者的家庭支持管理任重道远。
Objective To investigate the current status of family support for patients with heart failure in communities in Chengdu in order to propose more effective patterns of intervention in patients with heart failure. Methods From May to December 2009, two districts of Supo community in Qingyang District of Chengdu City and the east community community in Xindu District were selected as the investigation base. Cluster sampling was used to investigate the clinical features of 165 cases of New York Heart Function Cross-sectional baseline surveys were performed in patients with grade II-IV heart failure by questionnaire (85 patients in Xindu-Chengdong Community and 80 in Supo Community). Results Family composition of heart failure patients (8.5% of living alone / widowed or widowed or widowed with heart failure; widowed or divorced 17% of children living with children or nannies; 74.5% of family members living with spouses and / or children living with them) (60.4% of spouses; 32.9% of children; relatives, friends, nannies, caregivers or 6.7% of them taking care of themselves), relatives’ participation in management (overall management of patients with family therapy 11.2%, occasional participation 50.3% of patients with family therapy, (38.5% of patients treated at home), patients’ needs for family support (10.9% are needed very much, 25.5% are needed, 62.4% are not required, and 1.2% are not strongly determined). The patient’s age and degree of illness have some correlation with their needs for family support. Conclusion The spouse is the most prominent family supporter of disease management in community-based patients with heart failure in Chengdu, followed by children. Most of the community-based patients with heart failure in Chengdu lack effective family support, and most patients also believe that their illness does not require family support. Old age, heart failure symptoms of urgent need for family support. Family support issues for single-person patients are particularly prominent in older patients. Community support for patients with heart failure patients has a long way to go.