【摘要】 目的 构建基于二元疾病管理理论的慢性心力衰竭（chronic heart failure, CHF）患者及其照顾者正念自我关怀干预方案并探究其小规模应用效果。方法 前瞻性选取2024年1—10月收治的100对CHF患者及其照顾者作为研究对象，排除调查数据无效者后最终纳入92对患者及其照顾者进行分析，以随机数字表法分为观察组和对照组各46对。其中对照组患者及其照顾者接受常规护理方案，观察组在常规护理基础上加用基于二元疾病管理理论的正念自我关怀方案进行干预。采用汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）、自我同情量表（SCS）及正念注意觉知量表（MAAS）比较两组患者及照顾者干预前（T₁）、干预后即刻（T₂）、干预后1个月（T₃）时的焦虑、抑郁情绪、自我关怀及正念水平，采用照顾者积极感受量表（PAC）评估照顾者各时间点的照顾积极感受。结果 观察组患者及照顾者T₂、T₃时HAMA及HAMD评分均低于对照组，SCS评分均高于对照组（P<0.05），重复方差分析显示HAMA、HAMD及SCS评分组间、时间、组间×时间交互比较差异有统计学意义（P<0.05）；观察组患者及照顾者T₂、T₃时MAAS评分水平均高于对照组，重复方差分析显示两组患者及照顾者MAAS评分组间、时间、组间×时间交互比较差异有统计学意义（P<0.05）；观察组照顾者T₂、T₃时PAC评分水平均高于对照组，重复方差分析显示两组照顾者PAC评分组间、时间、组间×时间交互比较差异有统计学意义（P<0.05）。结论 基于二元疾病管理理论的CHF患者及其照顾者正念自我关怀干预方案能有效降低患者及照顾者负面情绪，提高患者及照顾者正念与自我关怀，具有临床应用潜力。更多还原

【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 signifi-cantly 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.更多还原