Lee Haejung, Yoon Ju Young, Lim Yeonjung, Jung HeeYoung, Kim Sungmin, Yoo Younja, Kim Yunseong, Ahn Jong-Joon, Park Hye-Kyung
College of Nursing, Pusan National University, Yangsan, Republic of Korea.
School of Nursing, University of Wisconsin-Madison, Madison, WI, USA.
Age Ageing. 2015 May;44(3):397-403. doi: 10.1093/ageing/afu201. Epub 2014 Dec 29.
to examine the effects of nurse-led, problem-solving therapy (PST) on coping, self-efficacy and depressive symptoms for patients with chronic obstructive pulmonary disease (COPD) using a randomised controlled trial.
a total of 254 patients with COPD were recruited, screened and randomly allocated into the intervention group with nurse-led PST or the comparison group with usual care. A total of 151 patients (intervention = 78 and comparison = 73) completed the study for 6 months.
the nurse-led PST was an individualised and patient-centred intervention to improve patients' problem-solving skills related to symptom management and lifestyle modification. Twelve telephone-based PST sessions were provided to the intervention group, while the control group received usual care from their primary care providers.
there were no group differences of post-test scores in problem-oriented coping, self-efficacy and depressive symptoms between the two groups. However, despite the lack of group differences, the nurse-led PST was effective for clinically depressed patients with COPD, who experienced decreased depressive symptoms (mean difference = 6.8, P = 0.009) and increased self-efficacy (mean difference = -0.6, P = 0.041) in the intervention group (n = 12).
the nurse-led PST offered to patients with COPD did not demonstrate any different effects compared with usual care over 6 months; however, a subgroup analysis with clinically depressed subjects showed improved self-efficacy and decreased depressive symptoms in the intervention group.
采用随机对照试验，研究由护士主导的问题解决疗法（PST）对慢性阻塞性肺疾病（COPD）患者应对能力、自我效能感和抑郁症状的影响。
共招募、筛选了254例COPD患者，并将其随机分为接受护士主导PST的干预组和接受常规护理的对照组。共有151例患者（干预组 = 78例，对照组 = 73例）完成了为期6个月的研究。
护士主导的PST是一种个体化的、以患者为中心的干预措施，旨在提高患者在症状管理和生活方式改变方面的问题解决能力。干预组接受了12次基于电话的PST疗程，而对照组则接受初级医疗服务提供者的常规护理。
两组在面向问题的应对、自我效能感和抑郁症状的测试后得分上没有组间差异。然而，尽管没有组间差异，但护士主导的PST对临床上患有COPD的抑郁症患者有效，干预组（n = 12）的抑郁症状有所减轻（平均差异 = 6.8，P = 0.009），自我效能感有所提高（平均差异 = -0.6，P = 0.041）。
为COPD患者提供的护士主导的PST在6个月内与常规护理相比未显示出任何不同的效果；然而，对临床上患有抑郁症的受试者进行的亚组分析显示，干预组的自我效能感有所提高，抑郁症状有所减轻。
