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一项由护士主导的教育性电话干预对慢性阻塞性肺疾病患者自我管理支持作用的评估:一项随机可行性研究

Evaluation of a Nurse-Led Educational Telephone Intervention to Support Self-Management of Patients With Chronic Obstructive Pulmonary Disease: A Randomized Feasibility Study.

作者信息

Billington Julia, Coster Samantha, Murrells Trevor, Norman Ian

机构信息

a Central Surgery, Surbiton Health Centre , Surbiton , Surrey , United Kingdom.

出版信息

COPD. 2015 Aug;12(4):395-403. doi: 10.3109/15412555.2014.974735.


DOI:10.3109/15412555.2014.974735
PMID:25474080
Abstract

UNLABELLED: This randomized, two armed feasibility study in a UK General Practice Surgery investigated the feasibility of introducing a nurse-led educational telephone intervention for patients with chronic obstructive pulmonary disease (COPD) to reinforce their understanding and use of their self-management plan. METHODS: 73 patients were randomly allocated to a control group which received standard care including a self-management plan or an intervention group which received in addition, two scheduled telephone calls over six weeks from a practice nurse. Calls were tailored to the needs of the patient, but provided education about the use of their plan to manage exacerbations, use of health services and emergency medication. The primary endpoint to be tested was the impact of symptoms assessed by the COPD Assessment Tool (CAT) at baseline and 12 weeks. Secondary endpoints were self-reported exacerbations, emergency visits and service satisfaction. RESULTS: Follow-up CAT data was available for 69 of the 73 randomized patients. CAT scores in the intervention group decreased significantly showing improvement between time 1 and 2 (Time 1 = 15.56 vs 12.44 at Time 2, Mean difference: 3.12, CI 1.52 -4.72, p <0.05) with no significant change in the control group. A significant difference between the CAT scores of the intervention and control groups was found at time 2 adjusting for baseline CAT scores at time 1 (-2.38 (-4.40 to -0.36) p <0.05.) No significant change was found in exacerbations between the groups at time 2. Satisfaction ratings did not vary significantly between the intervention and control groups over time. CONCLUSION: A nurse-led telephone intervention is feasible in primary care and may help to improve patients' health and well-being.

摘要

未标注:这项在英国一家普通外科诊所进行的随机、双臂可行性研究,调查了为慢性阻塞性肺疾病(COPD)患者引入由护士主导的教育性电话干预措施以加强他们对自我管理计划的理解和使用的可行性。 方法:73名患者被随机分配到对照组,该组接受包括自我管理计划在内的标准护理,或干预组,干预组除了接受标准护理外,还在六周内接受来自执业护士的两次定期电话随访。电话随访根据患者需求进行定制,但提供了关于如何使用计划来管理病情加重、使用医疗服务和应急药物的教育。要测试的主要终点是在基线和12周时通过慢性阻塞性肺疾病评估工具(CAT)评估的症状影响。次要终点是自我报告的病情加重、急诊就诊和服务满意度。 结果:73名随机分组患者中有69名有随访CAT数据。干预组的CAT评分显著下降,显示在时间1和时间2之间有所改善(时间1 = 15.56,时间2 = 12.44,平均差异:3.12,CI 1.52 - 4.72,p < 0.05),而对照组无显著变化。在根据时间1的基线CAT评分进行调整后,在时间2发现干预组和对照组的CAT评分存在显著差异(-2.38(-4.40至-0.36),p < 0.05)。在时间2时,两组之间的病情加重情况没有显著变化。随着时间的推移,干预组和对照组的满意度评分没有显著差异。 结论:由护士主导的电话干预在初级保健中是可行的,可能有助于改善患者的健康和幸福感。

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