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患有危及生命的长期疾病的外科手术后患者对赋予患者权力的护士行为、患者激活和功能健康状况的认知。

Patient perceptions of patient-empowering nurse behaviours, patient activation and functional health status in postsurgical patients with life-threatening long-term illnesses.

作者信息

Jerofke Teresa, Weiss Marianne, Yakusheva Olga

出版信息

J Adv Nurs. 2014 Jun;70(6):1310-22. doi: 10.1111/jan.12286.

Abstract

AIM

To explore the trajectory of associations between the nursing care process of patient empowerment during postsurgical hospitalization and postdischarge patient self-management outcomes, specifically patient activation and functional health status.

BACKGROUND

Patient-centred care models advocate for patient empowerment in long-term illness care. Postsurgical patients with life-threatening long-term illnesses frequently feel powerless, have unmet needs, decreased functional health status and high readmission rates; however, previous studies of patient empowerment have conceptualized empowerment as an outcome primarily in outpatient settings, with little attention paid to provider processes used to empower patients during hospitalizations.

DESIGN

A non-experimental, prospective, correlational study.

METHODS

This sample consisted of 113 postsurgical cancer and cardiac patients enrolled between August 2012–February 2013. Patient perceptions of patient-empowering nurse behaviours and baseline patient activation were measured prior to discharge. Patient activation and functional health status were measured 6 weeks following discharge. Data were analysed with multiple linear regression using a simultaneous equation approach.

RESULTS

Patients reported high perceptions of patient-empowering nurse behaviours and patient activation levels. Functional health status scores were below population norms. Patient perceptions of empowering nurse behaviours were positively associated with postdischarge patient activation, which was positively associated with mental functional health status. Length of stay was the only significant predictor of physical functional health status.

CONCLUSION

This study provides further quantitative evidence supporting the relationship between quality nursing care and postdischarge patient outcomes. Intentional use of patient-empowering nurse behaviours could lead to improved patient activation and functional health status in postsurgical patients with life-threatening long-term illnesses.

摘要

目的

探讨术后住院期间患者赋权护理过程与出院后患者自我管理结果之间的关联轨迹,特别是患者激活和功能健康状况。

背景

以患者为中心的护理模式提倡在长期疾病护理中赋予患者权力。患有危及生命的长期疾病的术后患者经常感到无力,有未满足的需求,功能健康状况下降且再入院率高;然而,以往关于患者赋权的研究主要将赋权概念化为门诊环境中的一种结果,很少关注在住院期间用于赋予患者权力的医护过程。

设计

一项非实验性、前瞻性、相关性研究。

方法

本样本包括2012年8月至2013年2月期间招募的113名术后癌症和心脏病患者。在出院前测量患者对赋予患者权力的护士行为的认知以及基线患者激活情况。在出院后6周测量患者激活和功能健康状况。使用联立方程方法通过多元线性回归分析数据。

结果

患者报告对赋予患者权力的护士行为和患者激活水平的认知较高。功能健康状况评分低于总体规范。患者对赋予权力的护士行为的认知与出院后患者激活呈正相关,而出院后患者激活与心理功能健康状况呈正相关。住院时间是身体功能健康状况的唯一显著预测因素。

结论

本研究提供了进一步的定量证据,支持优质护理与出院后患者结果之间的关系。有意使用赋予患者权力的护士行为可能会改善患有危及生命的长期疾病的术后患者的激活和功能健康状况。

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