Bobridge A, Sandison S, Paterson J, Puckridge P, Esplin M
School of Nursing, Flinders University, Bedford Park, South Australia, Australia.
Phlebology. 2011 Dec;26(8):338-43. doi: 10.1258/phleb.2010.010082. Epub 2011 May 13.
Chronic venous insufficiency (CVI) is a chronic condition that has a significant impact on the individual. For the effective, long-term management of CVI, it is important that patients are educated on the patho-physiology of the condition and strategies that can minimize the related complications. Therefore, the aim of this study was to develop and pilot a 'best practice' information booklet for CVI and to assess the impact of this booklet on CVI-related knowledge and quality of life (QOL).
A 'best practice' CVI booklet was developed based on the best available evidence from the literature. Participants with a formal diagnosis of CVI with a clinical, aetiological, anatomical and pathological elements (CEAP) classification of 3-6 were recruited from vascular outpatient clinics at a tertiary hospital. Each participant was given and explained the CVI booklet and asked to undertake the recommended activities at home over the next six-month period. Measurements were taken at baseline, one month and six months postbooklet implementation via the previously validated Health Education Impact and the CVI Questionnaires.
Twenty-six participants, aged 38-90 years (mean 71.8 ± 12.9 years) initially participated in the study, with 20 participants remaining at the six-month time point (77% completion rate). At the end of one month, there had been a significant improvement in doing at least one activity to improve CVI (P = 0.010), monitoring CVI (P = 0.045), having effective ways to prevent CVI symptoms (P = 0.045), knowing CVI triggers (P = 0.005), ability to travel by car and bus (P = 0.05), undertaking social activities (P = 0.030) and feeling less embarrassed about the legs (P = 0.025). At trial end (6 months), there was a significant improvement in doing at least one activity to improve CVI (P = 0.003), knowing CVI triggers (P = 0.016), having effective ways of preventing CVI symptoms (P = 0.008), worrying about the CVI (P = 0.030), feeling hopeless because of CVI problems (P = 0.007), leg and ankle pain (P = 0.038), ability to do domestic duties (P = 0.017), feeling nervous and tense (P = 0.026), and feeling less embarrassed about the legs (P = 0.008). Although other domains improved in the study, none of these improvements were statistically significant.
Although a small pilot study, the outcomes demonstrate that the implementation of a 'best practice' CVI information booklet into a patients management routine can improve both CVI-related knowledge and QOL.
慢性静脉功能不全(CVI)是一种对个体有重大影响的慢性疾病。为了对CVI进行有效、长期的管理,让患者了解该疾病的病理生理学以及能将相关并发症降至最低的策略非常重要。因此,本研究的目的是编写并试行一本针对CVI的“最佳实践”信息手册,并评估该手册对CVI相关知识和生活质量(QOL)的影响。
基于文献中可得的最佳证据编写了一本“最佳实践”CVI手册。从一家三级医院的血管门诊招募了经正式诊断为CVI且临床、病因、解剖和病理要素(CEAP)分类为3 - 6级的参与者。向每位参与者发放并讲解CVI手册,并要求他们在接下来的六个月里在家中进行推荐的活动。通过先前验证过的健康教育影响问卷和CVI问卷在基线、手册实施后1个月和6个月进行测量。
最初有26名年龄在38 - 90岁(平均71.8±12.9岁)的参与者参加了研究,在六个月时间点有20名参与者留存(完成率77%)。在1个月末,在进行至少一项改善CVI的活动(P = 0.010)、监测CVI(P = 0.045)、拥有预防CVI症状的有效方法(P = 0.045)、了解CVI诱因(P = 0.005)、乘坐汽车和公交车出行的能力(P = 0.05)、参加社交活动(P = 0.030)以及对腿部不再那么尴尬(P = 0.025)等方面有显著改善。在试验结束时(6个月),在进行至少一项改善CVI的活动(P = 0.003)、了解CVI诱因(P = 0.016)、拥有预防CVI症状的有效方法(P = 0.008)、担心CVI(P = 0.030)、因CVI问题感到绝望(P = 0.007)、腿部和脚踝疼痛(P = 0.038)、进行家务的能力(P = 0.017)、感到紧张(P = 0.026)以及对腿部不再那么尴尬(P = 0.008)等方面有显著改善。尽管在研究中其他领域也有改善,但这些改善均无统计学意义。
尽管这是一项小型试点研究,但结果表明将“最佳实践”CVI信息手册纳入患者管理常规可改善CVI相关知识和生活质量。