Fors Andreas, Taft Charles, Ulin Kerstin, Ekman Inger
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden Centre for Person-Centred Care, University of Gothenburg, Sweden Närhälsan Research and Development, Primary Health Care, Region Västra Götaland, Sweden
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden Centre for Person-Centred Care, University of Gothenburg, Sweden.
Eur J Cardiovasc Nurs. 2016 Apr;15(2):186-94. doi: 10.1177/1474515115623437. Epub 2015 Dec 23.
Person-centred care (PCC) aims to engage patients as active partners in their care and treatment to improve the management of their illness. Self-efficacy is an important concept and outcome in PCC as it refers to a patient's belief in their capability to manage the events that affect their lives. Recovery after acute coronary syndrome (ACS) is demanding and a PCC approach may promote self-efficacy and thereby facilitate recovery.
The purpose of this study was to evaluate whether a PCC intervention was able to improve self-efficacy after hospitalization for ACS.
In a randomized controlled trial, patients <75 years of age and hospitalized for ACS were assigned to either a usual care group or a PCC intervention group. Self-efficacy was assessed at baseline and up to six months after discharge using the Swedish Cardiac Self-Efficacy Scale (S-CSES), which consists of three dimensions: control symptoms, control illness and maintain functioning.
In total, 177 patients were included in the study: 93 in the usual care group and 84 in the PCC group. At the one-month follow-up the PCC group had improved significantly more (p=0.049) on the control symptoms dimension (mean change 0.81; SD 3.5 versus mean change -0.20; SD 3.0). No difference between groups was seen at the six-month follow-up in any of the S-CSES dimensions.
Our results indicate that PCC added to usual care promotes and hastens the development of patients' confidence in their ability to manage symptoms during recovery after ACS. This underlines the importance of initiating and establishing partnerships between patients and health care professionals as early as possible after ACS.
以患者为中心的护理（PCC）旨在让患者成为其护理和治疗的积极伙伴，以改善疾病管理。自我效能感是PCC中的一个重要概念和结果，因为它指的是患者相信自己有能力应对影响其生活的事件。急性冠状动脉综合征（ACS）后的康复要求很高，PCC方法可能会提高自我效能感，从而促进康复。
本研究的目的是评估PCC干预是否能够改善ACS住院后的自我效能感。
在一项随机对照试验中，将年龄小于75岁且因ACS住院的患者分为常规护理组或PCC干预组。使用瑞典心脏自我效能量表（S-CSES）在基线时和出院后长达6个月评估自我效能感，该量表包括三个维度：控制症状、控制疾病和维持功能。
总共177名患者纳入研究：常规护理组93名，PCC组84名。在1个月的随访中，PCC组在控制症状维度上的改善明显更多（p = 0.049）（平均变化0.81；标准差3.5，而平均变化-0.20；标准差3.0）。在6个月的随访中，S-CSES的任何维度上两组之间均未观察到差异。
我们的结果表明，在常规护理基础上增加PCC可促进并加速患者在ACS后康复期间对自身症状管理能力的信心发展。这强调了在ACS后尽早启动并建立患者与医疗保健专业人员之间伙伴关系的重要性。
