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提高成人先天性心脏病(健康、教育和参与研究试验:HEART-ACHD)患者的心脏病知识和研究参与度。

Improving heart disease knowledge and research participation in adults with congenital heart disease (the Health, Education and Access Research Trial: HEART-ACHD).

机构信息

Boston Adult Congenital Heart Program, Department of Cardiology, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA, USA.

出版信息

Int J Cardiol. 2013 Oct 9;168(4):3236-40. doi: 10.1016/j.ijcard.2013.04.004. Epub 2013 May 4.

Abstract

OBJECTIVE

The objective of this prospective multi-center study was to evaluate heart disease knowledge within the adult congenital heart disease (ACHD) population, pilot an educational intervention and assess interest in research participation among new patients at ACHD clinics.

BACKGROUND

Many adults with congenital heart disease lack knowledge about their heart condition that may contribute to undesirable outcomes.

METHODS

Patients ≥18 years of age were recruited upon their first presentation to an ACHD clinic and underwent an educational intervention consisting of creation of a personal health information 'passport' and an introduction to web-based resources. Subjects were asked to complete initial and follow-up surveys documenting their perceived knowledge.

RESULTS

Nine hundred twenty-two subjects were recruited from 12 ACHD centers, and 520 (57%) completed follow-up surveys. Patients who completed the follow-up survey were more likely to be women, have more education, and have mild heart disease. At follow-up, the ability of the subjects to name their heart condition improved (78% to 83%, p=0.002). Improvements were seen in mean Likert items regarding perceived knowledge of appropriate exercise (p<0.0001), symptoms of heart rhythm problems or endocarditis (p<0.0001), reasons for cardiac tests (p<0.007), and birth control options and pregnancy safety (p<0.0001). On follow-up, subjects reported a better understanding of medical research (p<0.01), and higher interest in research participation (p<0.003).

CONCLUSION

This joint clinician-patient pilot program will help inform future efforts toward patient education and participation in research with a focus on standardization of protocols for life-long longitudinal follow-up and continued multi-center collaboration in the ACHD population.

摘要

目的

本前瞻性多中心研究的目的在于评估成人先天性心脏病(ACHD)患者的心脏病知识,对教育干预进行试点,并评估 ACHD 诊所新患者对参与研究的兴趣。

背景

许多患有先天性心脏病的成年人对其心脏状况缺乏了解,这可能导致不良后果。

方法

在首次就诊于 ACHD 诊所时,招募年龄≥18 岁的患者,并进行包括创建个人健康信息“护照”和介绍基于网络的资源的教育干预。要求患者完成初始和随访调查,记录他们的感知知识。

结果

从 12 个 ACHD 中心招募了 922 名患者,其中 520 名(57%)完成了随访调查。完成随访调查的患者更可能为女性,受教育程度更高,且心脏病较轻。在随访时,患者能够说出自己的心脏病名称的能力有所提高(78%到 83%,p=0.002)。在感知适当运动知识、心脏节律问题或心内膜炎症状、心脏检查原因、避孕方法和妊娠安全性的平均李克特项目上,感知知识方面也有改善(均 p<0.0001)。随访时,患者报告对医学研究的理解有所提高(p<0.01),对参与研究的兴趣更高(p<0.003)。

结论

该联合临床医生-患者试点项目将有助于为未来的患者教育和参与研究提供信息,重点是制定终生纵向随访的标准化方案,并在 ACHD 人群中继续进行多中心合作。

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