Rose K, Waterman H, Toon L, McLeod D, Tullo A
School of Nursing, University of Manchester, UK.
Eye (Lond). 1999;13 ( Pt 1):71-5. doi: 10.1038/eye.1999.14.
To compare two organisational models of management for patients with cataract referred to a peripheral ophthalmic clinic who underwent day-surgery at a main eye hospital.
Patients were randomised into two groups. The experimental group (n = 25) received pre-operative assessment by a trained ophthalmic nurse at the peripheral clinic immediately following diagnosis of cataract and diary-booking for surgery. The control group (n = 24) received a separate appointment for pre-operative assessment at the main hospital. For all patients, the first review appointment (3 or 5 days post-operatively) and all subsequent review was at the peripheral clinic. Outcome measures included: visual acuity, subjective visual function (VF-14), anxiety and depression (HADS), semi-structured interviews to ascertain patient satisfaction, and a cost-benefit analysis.
There were no significant differences at any time between the experimental and control groups with respect to visual acuity, subjective visual function or anxiety and depression. The experimental model was found to be more cost-effective and provided a less fragmented means of care delivery. The majority of patients in both groups expressed satisfaction with their care but, overall, the experimental model was preferred.
Nurse-led pre-operative assessment of patients with cataract at a peripheral ophthalmic clinic is safe, cost-effective and is preferred by patients.
比较两种管理模式，针对转诊至周边眼科诊所且在主要眼科医院接受日间手术的白内障患者。
患者被随机分为两组。实验组（n = 25）在周边诊所被诊断为白内障后，由经过培训的眼科护士立即进行术前评估并预约手术日期。对照组（n = 24）在主要医院另行安排术前评估。所有患者的首次复查预约（术后3天或5天）及所有后续复查均在周边诊所进行。观察指标包括：视力、主观视觉功能（VF - 14）、焦虑和抑郁（医院焦虑抑郁量表）、用于确定患者满意度的半结构化访谈以及成本效益分析。
实验组和对照组在视力、主观视觉功能或焦虑抑郁方面在任何时间均无显著差异。发现实验模式更具成本效益，且提供了一种护理服务更连贯的方式。两组中的大多数患者对其护理表示满意，但总体而言，患者更倾向于实验模式。
由护士主导在周边眼科诊所对白内障患者进行术前评估是安全、具有成本效益且为患者所偏好的。
