由全科社区护士实施的简短生活方式干预的疗效试验（CN SNAP 试验）。

An efficacy trial of brief lifestyle intervention delivered by generalist community nurses (CN SNAP trial).

机构信息

Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales, Sydney NSW 2052, Australia.

出版信息

BMC Nurs. 2010 Feb 23;9:4. doi: 10.1186/1472-6955-9-4.

DOI:10.1186/1472-6955-9-4

PMID:20175932

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2841173/

Abstract

BACKGROUND

Lifestyle risk factors, in particular smoking, nutrition, alcohol consumption and physical inactivity (SNAP) are the main behavioural risk factors for chronic disease. Primary health care (PHC) has been shown to be an effective setting to address lifestyle risk factors at the individual level. However much of the focus of research to date has been in general practice. Relatively little attention has been paid to the role of nurses working in the PHC setting. Community health nurses are well placed to provide lifestyle intervention as they often see clients in their own homes over an extended period of time, providing the opportunity to offer intervention and enhance motivation through repeated contacts. The overall aim of this study is to evaluate the impact of a brief lifestyle intervention delivered by community nurses in routine practice on changes in clients' SNAP risk factors.

METHODS/DESIGN: The trial uses a quasi-experimental design involving four generalist community nursing services in NSW Australia. Services have been randomly allocated to an 'early intervention' group or 'late intervention' (comparison) group. 'Early intervention' sites are provided with training and support for nurses in identifying and offering brief lifestyle intervention for clients during routine consultations. 'Late intervention site' provide usual care and will be offered the study intervention following the final data collection point. A total of 720 generalist community nursing clients will be recruited at the time of referral from participating sites. Data collection consists of 1) telephone surveys with clients at baseline, three months and six months to examine change in SNAP risk factors and readiness to change 2) nurse survey at baseline, six and 12 months to examine changes in nurse confidence, attitudes and practices in the assessment and management of SNAP risk factors 3) semi-structured interviews/focus with nurses, managers and clients in 'early intervention' sites to explore the feasibility, acceptability and sustainability of the intervention.

DISCUSSION

The study will provide evidence about the effectiveness and feasibility of brief lifestyle interventions delivered by generalist community nurses as part of routine practice. This will inform future community nursing practice and PHC policy.

TRIAL REGISTRATION

ACTRN12609001081202.

摘要

背景

生活方式风险因素，尤其是吸烟、营养、饮酒和缺乏身体活动（SNAP），是慢性病的主要行为风险因素。初级卫生保健（PHC）已被证明是在个体层面解决生活方式风险因素的有效场所。然而，迄今为止，研究的重点大多集中在全科医生。相对较少关注在 PHC 环境中工作的护士的作用。社区卫生护士非常适合提供生活方式干预，因为他们经常在较长时间内在客户自己的家中看到客户，从而有机会通过多次联系提供干预并增强动力。这项研究的总体目标是评估社区护士在常规实践中进行简短生活方式干预对客户 SNAP 风险因素变化的影响。

方法/设计：该试验采用准实验设计，涉及澳大利亚新南威尔士州的四个全科社区护理服务。服务已被随机分配到“早期干预”组或“晚期干预”（比较）组。“早期干预”站点为护士提供培训和支持，以在常规咨询中识别和为客户提供简短的生活方式干预。“晚期干预”站点提供常规护理，并将在最后一次数据收集点后提供研究干预。共有 720 名全科社区护理客户将在参与站点转介时招募。数据收集包括 1）在基线、三个月和六个月时对客户进行电话调查，以检查 SNAP 风险因素的变化和改变的准备情况；2）在基线、六个月和十二个月时对护士进行调查，以检查护士在评估和管理 SNAP 风险因素方面的信心、态度和实践的变化；3）在“早期干预”站点对护士、经理和客户进行半结构化访谈/焦点小组，以探讨干预的可行性、可接受性和可持续性。