一项社区护理干预的随机对照试验：改善慢性腿部溃疡患者的生活质量并促进伤口愈合

A randomised controlled trial of a community nursing intervention: improved quality of life and healing for clients with chronic leg ulcers.

作者信息

Edwards Helen, Courtney Mary, Finlayson Kathleen, Shuter Patricia, Lindsay Ellie

机构信息

Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.

出版信息

J Clin Nurs. 2009 Jun;18(11):1541-9. doi: 10.1111/j.1365-2702.2008.02648.x.

DOI:10.1111/j.1365-2702.2008.02648.x

PMID:19490293

Abstract

AIMS AND OBJECTIVE

The negative impact of chronic leg ulcers on quality of life is well documented. The aim of this study was to determine the effectiveness of a new community nursing model of care on quality of life, morale, depression, self-esteem, social support, healing, pain and functional ability of clients with chronic venous leg ulcers.

BACKGROUND

Venous leg ulcers are slow to heal, frequently recur and are associated with pain, restricted mobility and decreased quality of life. Although chronic wound care consumes a large proportion of community nursing time and health care resources, there is little evidence available on the effectiveness of differing models of community care for this population.

DESIGN

Randomised controlled trial.

METHODS

We recruited a sample of 67 participants with venous leg ulcers referred for care to a community nursing organisation in Queensland, Australia after obtaining informed consent. Participants were randomised to either the Lindsay Leg Club model of care (n = 34), emphasising socialisation and peer support; or the traditional community nursing model (n = 33) consisting of individual home visits by a registered nurse. Participants in both groups were treated by a core team of nurses using identical research protocols based on short-stretch compression bandage treatment. Data were collected at baseline, 12 and 24 weeks from commencement.

RESULTS

Participants who received care under the Leg Club model demonstrated significantly improved outcomes in quality of life (p = 0.014), morale (p < 0.001), self-esteem (p = 0.006), healing (p = 0.004), pain (p = 0.003) and functional ability (p = 0.044).

CONCLUSION

In this sample, the evaluation of the Leg Club model of care shows potential to improve the health and well-being of clients who have chronic leg ulcers.

RELEVANCE TO CLINICAL PRACTICE

These results suggest further evaluation and implementation of this model is warranted by community health organisations involved in the care of this population.

摘要

目的与目标

慢性腿部溃疡对生活质量的负面影响已有充分记录。本研究的目的是确定一种新的社区护理模式对慢性下肢静脉溃疡患者的生活质量、士气、抑郁、自尊、社会支持、愈合、疼痛和功能能力的有效性。

背景

下肢静脉溃疡愈合缓慢，经常复发，并伴有疼痛、行动受限和生活质量下降。尽管慢性伤口护理消耗了社区护理时间和医疗资源的很大一部分，但关于不同社区护理模式对该人群有效性的证据却很少。

设计

随机对照试验。

方法

在获得知情同意后，我们招募了67名患有下肢静脉溃疡并被转介到澳大利亚昆士兰州一个社区护理组织接受护理的参与者。参与者被随机分为两组，一组接受林赛腿部俱乐部护理模式（n = 34），该模式强调社交和同伴支持；另一组接受传统社区护理模式（n = 33），即由注册护士进行单独家访。两组参与者均由一组核心护士按照基于短程弹力绷带治疗的相同研究方案进行治疗。在开始治疗后的基线、12周和24周收集数据。