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综合症状日记干预以改善 HF 患者的结局:一项试点研究。

A comprehensive symptom diary intervention to improve outcomes in patients with HF: a pilot study.

机构信息

School of Nursing, University of Wisconsin, Madison, Wisconsin.

出版信息

J Card Fail. 2013 Sep;19(9):647-54. doi: 10.1016/j.cardfail.2013.07.001.

Abstract

BACKGROUND

Patients with heart failure must monitor for and recognize escalating symptoms to take action to relieve symptoms and decrease hospitalizations. However, symptom monitoring is not commonly performed. One way to promote patients' engagement in symptom monitoring is by providing a symptom diary.

PURPOSE

The aim of this study was to test the effect of a comprehensive daily symptom diary intervention on event-free survival and health-related quality of life (HRQOL).

METHODS

Patients were randomized into either intervention (n = 23) or usual-care groups (n = 21). The intervention group received a symptom diary with self-care education and counseling at baseline with 5 follow-up calls for 3 months. All patients were interviewed to obtain survival data at 1 month and 3 months. HRQOL was measured at baseline, 1 month, and 3 months. Kaplan-Meier curves with the log-rank test were used to compare group differences in time to first event. Linear mixed models were conducted to examine the relationship between groups and changes in HRQOL over 3 months.

RESULTS

The intervention group had longer event-free survival than the usual-care group (P = .03). There were no differences in changes in HRQOL scores between the groups over 3 months.

CONCLUSIONS

Positive effects of the intervention on survival were found. However, there was no significant difference in changes in HRQOL.

摘要

背景

心力衰竭患者必须监测和识别症状加重,以便采取行动缓解症状并减少住院次数。然而,症状监测并不常见。促进患者参与症状监测的一种方法是提供症状日记。

目的

本研究旨在测试综合日常症状日记干预对无事件生存和健康相关生活质量(HRQOL)的影响。

方法

患者被随机分为干预组(n=23)和常规护理组(n=21)。干预组在基线时接受症状日记和自我护理教育,并在 3 个月内进行 5 次随访电话。所有患者均在 1 个月和 3 个月接受生存数据访谈。在基线、1 个月和 3 个月时测量 HRQOL。使用 Kaplan-Meier 曲线和对数秩检验比较两组首次事件的时间差异。使用线性混合模型检验 3 个月内 HRQOL 变化与组间的关系。

结果

干预组的无事件生存率高于常规护理组(P=.03)。两组在 3 个月内的 HRQOL 评分变化无差异。

结论

干预对生存有积极影响。然而,HRQOL 变化没有显著差异。

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