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考察患者导航干预对门诊心脏康复意识和参与度的影响。

Examining the effect of a patient navigation intervention on outpatient cardiac rehabilitation awareness and enrollment.

机构信息

Program in Public Health and School of Health Technology and Management, Stony Brook University Health Sciences Center, Stony Brook, NY 11794, USA.

出版信息

J Cardiopulm Rehabil Prev. 2013 Sep-Oct;33(5):281-91. doi: 10.1097/HCR.0b013e3182972dd6.

Abstract

PURPOSE

Awareness of and enrollment in outpatient cardiac rehabilitation (OCR) following a cardiac event or procedure remain suboptimal. Thus, it is important to identify new approaches to improve these outcomes. The objectives of this study were to identify (1) the contributions of a patient navigation (PN) intervention and other patient characteristics on OCR awareness; and (2) the contributions of OCR awareness and other patient characteristics on OCR enrollment among eligible cardiac patients up to 12 weeks posthospitalization.

METHODS

In this randomized controlled study, 181 eligible and consenting patients were assigned to either PN (n = 90) or usual care (UC; n = 91) prior to hospital discharge. Awareness of OCR was assessed by telephone interview at 12 weeks posthospitalization, and OCR enrollment was confirmed by staff at collaborating OCR programs. Of the 181 study participants, 3 died within 1 month of hospital discharge and 147 completed the 12-week telephone interview.

RESULTS

Participants in the PN intervention arm were nearly 6 times more likely to have at least some awareness of OCR than UC participants (OR = 5.99; P = .001). Moreover, participants who reported at least some OCR awareness were more than 9 times more likely to enroll in OCR (OR = 9.27, P = .034) and participants who were married were less likely to enroll (P = .031).

CONCLUSIONS

Lay health advisors have potential to improve awareness of outpatient rehabilitation services among cardiac patients, which, in turn, can yield greater enrollment rates in a program.

摘要

目的

心脏病发作或手术后,患者对门诊心脏康复(OCR)的认知和参与度仍然不理想。因此,寻找改善这一结果的新方法非常重要。本研究的目的是:(1)确定患者导航(PN)干预和其他患者特征对 OCR 认知的影响;(2)确定 OCR 认知和其他患者特征对符合条件的心脏病患者在住院后 12 周内参与 OCR 的影响。

方法

在这项随机对照研究中,在出院前将 181 名符合条件并同意参与的患者分为 PN 组(n = 90)或常规护理组(UC;n = 91)。通过 12 周后电话访谈评估 OCR 认知度,在合作 OCR 项目的工作人员处确认 OCR 参与情况。在 181 名研究参与者中,3 人在出院后 1 个月内死亡,147 人完成了 12 周的电话访谈。

结果

PN 干预组的参与者对 OCR 的认知程度至少比 UC 组高近 6 倍(OR = 5.99;P =.001)。此外,报告至少有一些 OCR 认知度的参与者参加 OCR 的可能性高出 9 倍以上(OR = 9.27,P =.034),已婚参与者参加 OCR 的可能性较小(P =.031)。

结论

非专业医疗保健顾问有可能提高心脏病患者对门诊康复服务的认知度,从而提高该项目的参与率。

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