Duelund-Jakobsen J, Haas S, Buntzen S, Lundby L, Bøje G, Laurberg S
Surgical Research Unit, Department of Surgery P, Aarhus University Hospital, Tage-Hansens Gade, Aarhus C, Denmark.
Colorectal Dis. 2015 Aug;17(8):710-5. doi: 10.1111/codi.12983.
In May 2010, a specialist nurse-initiated assessment and treatment algorithm for faecal incontinence (FI) was introduced at the department of Anal Physiology, Aarhus University Hospital, Denmark. This study aimed to evaluate the effectiveness of and patient satisfaction with the program.
A medical file audit was preformed on patients evaluated and treated for FI and discharged after September 2010. Patients were invited to participate in a structured telephone interview. This study aimed to enrol 100 patients. Patients were asked if they were satisfied with their current level of continence status (yes/no), and a numerical satisfaction score and Wexner score were recorded. These results were compared to baseline and at time of discharge.
One-hundred patients completed the telephone interview; 73 of these patients were satisfied after a median of 420 (range: 114-586) days following discharge from the program. A median of one outpatient consultation followed by one telephone follow-up was required before the patients were discharged. The Wexner score was significantly reduced by 3.9 (±4.4) (P < 0.001) points among the satisfied and non-significantly reduced by 0.52 (± 3.3) (P = 0.42) points among the dissatisfied patients at follow-up compared to baseline. The satisfied and dissatisfied patients at follow-up did not differ in baseline characteristics including Wexner score.
FI can successively be evaluated and conservatively managed by specialist nurses, and these nurses achived high satisfaction rates among their patients. The concept of specialist nurse-led clinics will reduce waiting lists, and descrease the number of patients needing to be evaluated by a surgeon.
2010年5月，丹麦奥胡斯大学医院肛门生理学系引入了由专科护士发起的粪便失禁（FI）评估和治疗方案。本研究旨在评估该方案的有效性及患者满意度。
对2010年9月后接受FI评估和治疗并出院的患者进行病历审核。邀请患者参与结构化电话访谈。本研究计划招募100名患者。询问患者对其当前控便状态是否满意（是/否），并记录数值满意度评分和韦克斯纳评分。将这些结果与基线和出院时进行比较。
100名患者完成了电话访谈；其中73名患者在该方案出院后的中位420天（范围：114 - 586天）后表示满意。患者出院前平均需要进行一次门诊咨询和一次电话随访。随访时，满意患者的韦克斯纳评分较基线显著降低3.9（±4.4）分（P < 0.001），不满意患者的韦克斯纳评分较基线非显著降低0.52（±3.3）分（P = 0.42）。随访时满意和不满意患者在包括韦克斯纳评分在内的基线特征方面无差异。
专科护士可以成功地对FI进行评估和保守管理，并且这些护士在患者中获得了较高的满意度。专科护士主导诊所的概念将减少候诊名单，并减少需要外科医生评估的患者数量。
