Kutzleb Judith, Reiner Dana
Emergency Services, Holy Name Hospital, Teaneck, NJ, USA.
J Am Acad Nurse Pract. 2006 Mar;18(3):116-23. doi: 10.1111/j.1745-7599.2006.00107.x.
The purpose of this research was to evaluate the impact of a nurse-directed approach to patient education, which focused on lifestyle modification, daily weight management, diet, and medication compliance to improve the quality of life (QOL) and functional capacity in people with heart failure.
This was a prospective quasiexperimental multicenter research study of 23 patients comparing a nurse-directed care (NC) group (n = 13), which received comprehensive disease management education and weekly telephone follow-up, and the routine care (RC) group (n = 10) that received protocol-driven medical management. The study length was 12 months.
Analysis of covariance (ANCOVA) was used to test for equality of variance-covariance matrices in the study population over time. ANCOVA measured baseline and two data intervals for a total of 9 months between the control and experimental (NC and RC) groups. There was statistically significant improvement in the NC group for the domains of total QOL: F = 3.569, p = 0.000; health and function: F = 3.995, p = 0.003; social and economic: F = 14.109, p = 0.000; psychological and spiritual: F = 13.212, p = 0.000; and family: F = 2.384, p = 0.048. Functional capacity was not significantly impacted by the study team interventions (F = 0.228, p = 0.949).
Results indicate that nurse-directed patient education was effective in improving QOL. A nurse-directed treatment strategy significantly improves patients' role in symptom control and disease self-management.
本研究旨在评估以护士为主导的患者教育方法的影响，该方法侧重于生活方式改变、每日体重管理、饮食和药物依从性，以改善心力衰竭患者的生活质量（QOL）和功能能力。
这是一项前瞻性准实验性多中心研究，对23名患者进行了比较，其中护士主导护理（NC）组（n = 13）接受了全面的疾病管理教育和每周电话随访，常规护理（RC）组（n = 10）接受了方案驱动的医疗管理。研究时长为12个月。
采用协方差分析（ANCOVA）来检验研究人群随时间变化的方差 - 协方差矩阵的相等性。ANCOVA测量了对照组和实验组（NC和RC）之间共9个月的基线和两个数据间隔。NC组在总生活质量的各个领域均有统计学上的显著改善：F = 3.569，p = 0.000；健康与功能：F = 3.995，p = 0.003；社会与经济：F = 14.109，p = 0.000；心理与精神：F = 13.212，p = 0.000；以及家庭：F = 2.384，p = 0.048。功能能力未受到研究团队干预的显著影响（F = 0.228，p = 0.949）。
结果表明，以护士为主导的患者教育在改善生活质量方面是有效的。以护士为主导的治疗策略显著改善了患者在症状控制和疾病自我管理中的作用。
