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丙型肝炎自我管理计划:1 年时主要结局的可持续性。

The hepatitis C self-management program: sustainability of primary outcomes at 1 year.

机构信息

1VA San Diego Healthcare System, San Diego, CA, USA.

出版信息

Health Educ Behav. 2013 Dec;40(6):730-40. doi: 10.1177/1090198113477112. Epub 2013 Feb 27.

Abstract

OBJECTIVE

Chronic hepatitis C infection afflicts millions of people worldwide. Although antiviral treatments are increasingly effective, many hepatitis C virus (HCV) patients avoid treatment, do not complete or respond to treatment, or have contraindications. Self-management interventions are one option for promoting behavioral changes leading to liver wellness and improved quality of life. Our objective was to evaluate whether the effects of the HCV self-management program were sustained at the 12-month follow-up assessment.

METHODS

Veteran Affairs patients with hepatitis C (N = 134; mean age = 54.6 years, 95% male, 41% ethnic minority, 48% homeless in last 5 years) were randomized to either a 6-week self-management workshop or an information-only intervention. The weekly 2-hour self-management sessions were based on a cognitive-behavioral program with hepatitis C-specific modules. Outcomes including hepatitis C knowledge, depression, energy, and health-related quality of life were measured at baseline, 6 weeks, 6 months, and 12 months later. Data were analyzed using repeated measures ANOVA.

RESULTS

Compared with the information-only group, participants attending the self-management workshop improved more on HCV knowledge (p < .005), SF-36 energy/vitality (p = .016), and the Quality of Well-Being Scale (p = .036). Similar trends were found for SF-36 physical functioning and Center for Epidemiologic Studies Short Depression Scale.

CONCLUSION

Better outcomes were sustained among self-management participants at the 12-month assessment despite the intervention only lasting 6 weeks. HCV health care providers should consider adding self-management interventions for patients with chronic HCV.

摘要

目的

慢性丙型肝炎感染影响着全球数百万人。尽管抗病毒治疗越来越有效,但许多丙型肝炎病毒(HCV)患者避免治疗、未完成或对治疗无反应,或存在禁忌症。自我管理干预是促进导致肝脏健康和提高生活质量的行为改变的一种选择。我们的目的是评估 HCV 自我管理计划的效果是否在 12 个月的随访评估中持续存在。

方法

退伍军人事务部丙型肝炎患者(N=134;平均年龄=54.6 岁,95%为男性,41%为少数民族,48%在过去 5 年中无家可归)被随机分配到 6 周自我管理研讨会或信息干预组。每周 2 小时的自我管理课程基于具有 HCV 特定模块的认知行为计划。在基线、6 周、6 个月和 12 个月后测量丙型肝炎知识、抑郁、能量和健康相关生活质量等结果。使用重复测量方差分析进行数据分析。

结果

与信息组相比,参加自我管理研讨会的参与者在 HCV 知识(p<0.005)、SF-36 能量/活力(p=0.016)和健康幸福感量表(p=0.036)方面的改善更大。SF-36 身体功能和流行病学研究中心短抑郁量表也发现了类似的趋势。

结论

尽管干预仅持续 6 周,但自我管理参与者在 12 个月评估中仍保持更好的结果。慢性 HCV 医疗保健提供者应考虑为患者添加自我管理干预措施。

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