Collaborative care model improves self-care ability, quality of life and cardiac function of patients with chronic heart failure

Chronic heart failure (CHF) is a common chronic disease that requires much care. This study aimed to explore the effects of collaborative care model (CCM) on patients with CHF. A total of 114 CHF patients were enrolled in this study, and were randomly and equally divided into two groups: control and experimental. Patients in the two groups received either usual care or CCM for 3 continuous months. The impacts of CCM on the self-care ability and quality of life were assessed using self-care of heart failure index and short form health survey 12, respectively. Further, cardiac function was assessed by measuring left ventricular ejection fraction (LVEF) and the level of N-terminal pro-B-type natriuretic peptide (NT-proBNP), and by the 6-min walking test. Clinical and demographic characteristics of patients in the control and CCM groups were statistically equivalent. Compared with usual care, CCM significantly enhanced self-care abilities of patients with CHF, including self-care maintenance, self-care management and self-care confidence (all P<0.05). The physical and mental quality of life was also significantly improved by CCM (P<0.01 or P<0.05). Compared with usual care, CCM significantly increased the LVEF (P<0.01), decreased the NT-proBNP level (P<0.01), and enhanced exercise capacity (P<0.001). In conclusion, CCM improved the self-care, quality of life and cardiac function of patients with CHF compared with usual care.

慢性心力衰竭（Chronic Heart Failure, CHF）是一类需长期照护的常见慢性病。本研究旨在探讨协作照护模式（Collaborative Care Model, CCM）对慢性心力衰竭患者的干预效果。本研究共纳入114例慢性心力衰竭患者，采用完全随机化方法将其均分为对照组与实验组两组，两组患者分别接受常规照护与协作照护干预，干预周期均为连续3个月。本研究分别采用心力衰竭自我护理指数（Self-Care of Heart Failure Index）与简明健康调查问卷12项版（Short Form Health Survey 12），评估协作照护模式对患者自我护理能力与生活质量的影响；同时通过检测左心室射血分数（Left Ventricular Ejection Fraction, LVEF）与N末端B型利钠肽原（N-terminal pro-B-type natriuretic peptide, NT-proBNP）水平、开展6分钟步行试验，对患者的心脏功能进行评估。对照组与协作照护组患者的临床及人口学基线特征无统计学差异。与常规照护相比，协作照护模式可显著提升慢性心力衰竭患者的自我护理能力，涵盖自我护理维持、自我护理管理与自我护理信心三个维度（所有P<0.05）；同时可显著改善患者的躯体与精神生活质量（P<0.01或P<0.05）。与常规照护相比，协作照护模式可显著提升患者左心室射血分数（P<0.01）、降低N末端B型利钠肽原水平（P<0.01），并增强运动耐量（P<0.001）。综上，相较于常规照护，协作照护模式可有效改善慢性心力衰竭患者的自我护理能力、生活质量与心脏功能。