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基于跨理论模型的阶梯式营养管理方案对慢性心力衰竭患者营养状况改善的有效性
Authors Yuan D , Xue Y, Zhou Y
Received 29 November 2024
Accepted for publication 13 March 2025
Published 20 May 2025 Volume 2025:18 Pages 1683—1695
DOI http://doi.org/10.2147/RMHP.S509402
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Kyriakos Souliotis
Dejing Yuan,* Yuan Xue,* Yuefei Zhou
Department of Nursing, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yuefei Zhou, Email duduzhouyuefei@163.com
Objective: To explore the nutritional status of chronic heart failure (CHF) patients and evaluate the effect of a transtheoretical model-based stepwise nutritional management program on nutritional improvement.
Methods: This study conducted a retrospective analysis of 100 chronic heart failure (CHF) patients admitted to our hospital from March 2023 to May 2024. After applying inclusion and exclusion criteria, the patients were divided into an observation group and a control group. The observation group received a stepwise nutritional management program based on the transtheoretical model (TTM), while the control group received routine care. Nutritional improvement and clinical effects were compared between the two groups.
Results: Among the 100 CHF patients, 27% had good nutritional status, 42% were at nutritional risk, and 31% had malnutrition. No significant differences in baseline data were found between the two groups (P > 0.05). After the intervention, the observation group showed significantly lower B-type natriuretic peptide (BNP) levels and higher left ventricular ejection fraction (LVEF) levels compared to the control group (P < 0.05). Psychological scores (Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS)) in the observation group were also significantly lower than those in the control group (P < 0.05). Additionally, serum total cholesterol (TC) and triglycerides (TG) levels were lower in the observation group (P < 0.05), and levels of prealbumin, transferrin, hemoglobin, and albumin were higher (P < 0.05). The Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores in the observation group were significantly lower than in the control group (P < 0.05).
Conclusion: The nutritional status of CHF patients is generally poor, and the transtheoretical model-based stepwise nutritional management program can effectively improve their nutritional status, enhance cardiac function, improve quality of life, and alleviate psychological burden. This intervention is promising for clinical practice.
Keywords: chronic heart failure, nutritional status, transtheoretical model, stepwise nutritional management, quality of life