中国护士主导的出院后电话支持性护理对接受腹膜透析的慢性肾病患者的影响：一项随机对照试验
Effects of post-discharge nurse-led telephone supportive care for patients with chronic kidney disease undergoing peritoneal dialysis in China: a randomized controlled trial.
作者信息
Li Juan, Wang Huizhen, Xie Hongzhen, Mei Guiping, Cai Wenzhi, Ye Junsheng, Zhang Jianlin, Ye Guirong, Zhai Huimin
机构信息
School of nursing, Southern Medical University, Guangzhou, Guangdong 510515, China; Department of Nursing, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China; Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China; and Department of Nephrology, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China.
出版信息
Perit Dial Int. 2014 May;34(3):278-88. doi: 10.3747/pdi.2012.00268. Epub 2014 Jan 2.
BACKGROUND
Patients with end-stage renal failure (ESRF) need integrated health care to maintain a desirable quality of life. Studies suggest that post-discharge nurseled telephone support has a positive effect for patients suffering from chronic diseases. But the post-discharge care is under-developed in mainland China and the effects of post-discharge care on patients with peritoneal dialysis have not been conclusive.
AIM
The purpose of this study is to test the effectiveness of postdischarge nurse-led telephone support on patients with peritoneal dialysis in mainland China.
METHODS
A randomized controlled trial was conducted in the medical department of a regional hospital in Guangzhou. 135 patients were recruited, 69 in the study group and 66 in the control group. The control group received routine hospital discharge care. The study group received post-discharge nurse-led telephone support. The quality of life (Kidney Disease Quality of Life Short Form, KDQOL-SF), blood chemistry, complication control, readmission and clinic visit rates were observed at three time intervals: baseline before discharge (T1), 6 (T2) and 12 (T3) weeks after discharge.
RESULTS
Statistically significant effects were found for symptom/problem, work status, staff encouragement, patient satisfaction and energy/fatigue in KDQOL-SF and 84-day (12-week) clinic visit rates between the two groups. The study group had more significant improvement than the control group for sleep, staff encouragement at both T2 and T3, and pain at T2 and patient satisfaction at T3. No significant differences were observed between the two groups for the baseline measures, other dimensions in KDQOL-SF, blood chemistry, complication control, readmission rates at all time intervals and clinic visit rates at the first two time intervals.
CONCLUSIONS
Post-discharge nurse-led telephone support for patients undergoing peritoneal dialysis is effective to enhance patients' well-being in the transition from hospital to home in mainland China.
背景
终末期肾衰竭（ESRF）患者需要综合医疗保健以维持理想的生活质量。研究表明，出院后由护士主导的电话支持对慢性病患者有积极影响。但中国大陆的出院后护理发展不足，且出院后护理对腹膜透析患者的影响尚无定论。
目的
本研究旨在检验中国大陆出院后由护士主导的电话支持对腹膜透析患者的有效性。
方法
在广州一家地区医院的内科进行了一项随机对照试验。招募了135名患者，研究组69名，对照组66名。对照组接受常规出院护理。研究组接受出院后由护士主导的电话支持。在三个时间点观察生活质量（肾脏病生活质量简表，KDQOL-SF）、血液生化指标、并发症控制情况、再入院率和门诊就诊率：出院前基线（T1）、出院后6周（T2）和12周（T3）。
结果
两组在KDQOL-SF中的症状/问题、工作状态、医护鼓励、患者满意度以及精力/疲劳方面，以及84天（12周）门诊就诊率上存在统计学显著差异。研究组在T2和T3时的睡眠、医护鼓励，T2时的疼痛以及T3时的患者满意度方面比对照组有更显著的改善。两组在基线指标、KDQOL-SF的其他维度、血液生化指标、各时间点的并发症控制情况、再入院率以及前两个时间点的门诊就诊率方面均未观察到显著差异。
结论
在中国大陆，出院后由护士主导的电话支持对接受腹膜透析的患者在从医院过渡到家庭的过程中提高其幸福感是有效的。
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