Namba Shihoko, Miyake Kayoko, Ikeda Fusao, Hazama Tomoko, Hitobe Yu, Yamasaki Noriko, Shiraha Hidenori, Takaki Akinobu, Nouso Kazuhiro, Iwasaki Yoshiaki, Yamamoto Kazuhide
Department of Nursing, Okayama University Hospital, Okayama 700-8558, Japan.
Acta Med Okayama. 2014;68(5):263-8. doi: 10.18926/AMO/52894.
Nursing support might help patients with chronic hepatitis C (CHC) remain in good mental and physical condition during interferon (IFN) therapy. However, the effects of nursing support have not been studied adequately in this context. This case-control study evaluated the effects of nursing support during IFN therapy. Twenty-four CHC patients who received pegylated IFN and ribavirin were enrolled. Nurses advised patients on the maintenance of their mental and physical condition at weekly visits, based on the results of written questionnaires. An additional 24 patients who received IFN therapy without nursing support and who were matched for age, sex, platelet count, viral serogroup and IFN regimen were selected with propensity score matching as controls. The patients with nursing support during IFN therapy achieved higher sustained virological responses (79%) than those without nursing support (58%). Adherence to the IFN and ribavirin regimens at 24 weeks of therapy were slightly higher in the patients with nursing support than those without it, but these differences were not statistically significant. Adherence to ribavirin after 24 weeks of therapy was significantly higher in those with nursing support than those without it (93% and 66%, p=0.045). These results suggested that nursing support services could contribute to the virological responses of CHC patients by promoting drug-regimen adherence.
护理支持可能有助于慢性丙型肝炎(CHC)患者在干扰素(IFN)治疗期间保持良好的身心状态。然而,在这种情况下,护理支持的效果尚未得到充分研究。本病例对照研究评估了IFN治疗期间护理支持的效果。招募了24例接受聚乙二醇化干扰素和利巴韦林治疗的CHC患者。护士根据书面问卷结果,在每周的访视中为患者提供关于维持身心状态的建议。另外通过倾向评分匹配选择了24例接受IFN治疗但无护理支持且在年龄、性别、血小板计数、病毒血清群和IFN治疗方案方面相匹配的患者作为对照。接受IFN治疗期间有护理支持的患者实现了更高的持续病毒学应答率(79%),高于无护理支持的患者(58%)。有护理支持的患者在治疗24周时对IFN和利巴韦林治疗方案的依从性略高于无护理支持的患者,但这些差异无统计学意义。治疗24周后,有护理支持的患者对利巴韦林的依从性显著高于无护理支持的患者(分别为93%和66%,p=0.045)。这些结果表明,护理支持服务可通过促进药物治疗方案的依从性,对CHC患者的病毒学应答产生影响。