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护士主导的患者自我管理干预措施在症状管理方面的解构:与实施和反应相关的因素。

Deconstruction of nurse-delivered patient self-management interventions for symptom management: factors related to delivery enactment and response.

机构信息

Department of Family Medicine, Michigan State University, East Lansing, MI, USA.

出版信息

Ann Behav Med. 2010 Aug;40(1):99-113. doi: 10.1007/s12160-010-9191-7.

Abstract

This research examines the processes by which patient self-management interventions are related to symptom responses among cancer patients. A total of 333 patients from two randomized clinical trials were combined. Each patient received a six-contact 8-week patient self-management intervention delivered by a nurse to address symptoms. Nurses' decisions to deliver the strategies, patient enactment of strategies, and their success were investigated using patient- and symptom-level characteristics. Generalized estimating equation modeling accounted for clustering of symptoms and strategies delivered for each symptom within patient. Patient self-management intervention strategies were classified into four classes. Strategies were delivered by nurses for symptoms with higher interference and longer duration. Patient and symptom factors were related to enactment strategies. Symptom responses were related to number of strategies tried by patients. Delivery and enactment of strategies were related to both patient and symptom characteristics.

摘要

本研究考察了患者自我管理干预与癌症患者症状反应之间的关系过程。将来自两项随机临床试验的 333 名患者进行了合并。每位患者接受了由护士提供的为期 8 周的 6 次接触的患者自我管理干预,以解决症状问题。使用患者和症状特征调查了护士决定提供策略、患者实施策略及其成功的情况。广义估计方程模型考虑了每个患者的症状和策略的聚类。患者自我管理干预策略分为四类。对于干扰程度更高、持续时间更长的症状,护士会提供相应的策略。患者和症状因素与实施策略有关。症状反应与患者尝试的策略数量有关。策略的提供和实施与患者和症状特征均有关。

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