关键词: 二元疾病管理理论, 慢性心力衰竭, 正念, 自我关怀

Abstract:

Objective To construct a mindfulness-based self-care intervention program for patients with chronic heart failure （CHF） and their caregivers based on binary disease management theory and explore its small-scale application effect. Methods A prospective study was conducted on 100 pairs of CHF patients admitted to our hospital and their caregivers from January 2024 to October 2024. After excluding those with invalid survey data， 92 pairs were finally included and randomly divided into an observation group and a control group， each consisting of 46 pairs. The control group received routine nursing care， while the observation group received the mindfulness-based self-care program based on binary disease management theory in addition to routine nursing care. The Hamilton Anxiety Scale （HAMA）， Hamilton Depression Scale （HAMD）， Self Compassion Scale （SCS）， and Mindfulness Attention Awareness Scale （MAAS） were used to compare the anxiety， depression， self-care， and mindfulness levels of patients and caregivers at three time points： pre-intervention （T₁）， right post-intervention（T₂）， and one month post-intervention （T₃）. The Caregiver Positive Perception Scale （PAC） was used to evaluate the caregiver's positive perception at each time point. Results The HAMA and HAMD scores of patients and caregivers in the observation group were lower than those in the control group at T2 and T3， while the SCS scores were significantly higher （all P < 0.05）. Repeated-measures analysis of variance showed significant differences in HAMA， HAMD， and SCS scores between groups over time， and in the interaction between time and time （all P < 0.05）. The MAAS scores of patients and caregivers in the observation group were also significantly higher at T₂ and T₃ compared to the control group. Repeated analysis of variance showed significant differences in MAAS scores between the two groups， at different times， and in the interaction of time between groups （all P < 0.05）. The PAC scores of caregivers in the observation group were significantly higher at T₂ and T₃， with significant differences in repeated-measures analysis of variance for group， time， and group × time interaction （all P < 0.05）. Conclusions The mindfulness-based self-care intervention program based on binary disease management theory effectively reduces negative emotions in patients and caregivers， and improves mindfulness and self-care， showing clinical application potential.

Key words: dual disease management theory, chronic heart failure, mindfulness, self-care