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心肌梗死后康复及二级预防的初级卫生保健资源——一项问卷调查

Primary health care resources for rehabilitation and secondary prevention after myocardial infarction - a questionnaire survey.

作者信息

Sjöström-Strand Annica, Ivarsson Bodil, Sjöberg Trygve

机构信息

Department of Cardiothoracic Surgery, Lund University and Skåne University Hospital/Lund, Lund, Sweden.

出版信息

Scand J Caring Sci. 2013 Jun;27(2):260-6. doi: 10.1111/j.1471-6712.2012.01025.x. Epub 2012 Jun 5.

Abstract

BACKGROUND

During the first year after a cardiac event, many patients are offered participation in a cardiac rehabilitation programme, after which the patients are often not given the opportunity to continue to attend rehabilitation and secondary prevention programmes.

AIM

This study describes the primary health care centres' (PHCC) resources regarding cardiac rehabilitation/secondary prevention programmes for coronary heart disease (CHD) patients in a southern Swedish region.

METHOD

A questionnaire containing 26 dichotomous or multiple choice questions was sent to the responsible manager of all 137 public and private PHCCs in Region Skåne. Questionnaires from 91 (66%) of the PHCCs were completed and returned.

RESULT

Few nurses at the PHCCs had special training regarding CHD (10%), cardiac rehabilitation (8%) or heart failure (32%). Twenty-one per cent of the physicians had special training regarding CHD. One third of the PHCCs did not offer long-term secondary prevention programmes, and few (6%) had any routines for offering socio-economic support to CHD patients. Comparison of private and public PHCCs showed that the private centres could not offer a physiotherapist (61 vs. 84%) or dietician (32 vs. 73%; p = 0.03) to the same extension as the public ones. Furthermore, the majority (91%) of PHCCs had no cooperation with patient organizations.

CONCLUSIONS

The PHCCs need to improve the strategies and long-term rehabilitation programmes. Furthermore, they need to focus on education programme for the staff. The result revealed that the PHCCs lack resources, strategies and long-term care programmes for CHD patients.

摘要

背景

在发生心脏事件后的第一年,许多患者被建议参加心脏康复计划,但在此之后,患者往往没有机会继续参加康复和二级预防计划。

目的

本研究描述了瑞典南部一个地区初级卫生保健中心(PHCC)针对冠心病(CHD)患者的心脏康复/二级预防计划的资源情况。

方法

向斯科讷地区所有137家公立和私立PHCC的负责人发送了一份包含26个二分法或多项选择题的问卷。91家(66%)PHCC完成并返回了问卷。

结果

PHCC中很少有护士接受过关于冠心病(10%)、心脏康复(8%)或心力衰竭(32%)的特殊培训。21%的医生接受过关于冠心病的特殊培训。三分之一的PHCC不提供长期二级预防计划,很少有(6%)有向冠心病患者提供社会经济支持的常规做法。公立和私立PHCC的比较表明,私立中心提供物理治疗师(61%对84%)或营养师(32%对73%;p = 0.03)的比例不如公立中心。此外,大多数(91%)PHCC与患者组织没有合作。

结论

PHCC需要改进策略和长期康复计划。此外,他们需要关注员工的教育计划。结果显示,PHCC缺乏针对冠心病患者的资源、策略和长期护理计划。

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