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一项针对住院哮喘康复的标准化患者教育项目评估:对患者报告的长达一年的健康结果的影响。

Evaluation of a standardized patient education program for inpatient asthma rehabilitation: Impact on patient-reported health outcomes up to one year.

作者信息

Bäuerle Kathrin, Feicke Janine, Scherer Wolfgang, Spörhase Ulrike, Bitzer Eva-Maria

机构信息

Department of Everyday Culture, Exercise and Health, University of Education, Freiburg, Germany.

Department of Biology and its Didactics, University of Education, Freiburg, Germany.

出版信息

Patient Educ Couns. 2017 May;100(5):957-965. doi: 10.1016/j.pec.2016.11.023. Epub 2016 Nov 28.

Abstract

OBJECTIVES

To modify and evaluate a patient education program for adult asthma patients in consideration of quality criteria for teaching.

METHODS

This was a prospective single-center controlled trial in an inpatient rehabilitation center. The control group (n=215) received the usual lecture-based education program, and the intervention group (n=209) the modified patient education program. Data were assessed at admission, discharge, 6 and 12 months post discharge. The primary outcome was asthma control, the secondary outcomes were asthma knowledge, quality of life, and program acceptance. Analysis of change was performed by ANCOVA for each follow-up, adjusting for baseline values.

RESULTS

Statistically significant increases in all health outcomes and in asthma control were maintained in both groups at 12 months: CG: +1.9 (95%-CI 1.3-2.6) IG: +1.6 (95%-CI 0.8-2.3). We observed no significant differences between the programs for asthma control and quality of life. Regarding practical asthma knowledge, after 12 months, a group*time interaction emerged with a small effect size (P=0.06, η2=0.01).

CONCLUSION

The modified program was not superior to traditional patient education concerning asthma control. It permanently increased self-management knowledge.

PRACTICAL IMPLICATIONS

Structured and behavioral patient education fosters patient's disease management ability. Possible ways of improving asthma control need to be explored.

摘要

目的

根据教学质量标准,修改并评估一项针对成年哮喘患者的患者教育项目。

方法

这是一项在住院康复中心进行的前瞻性单中心对照试验。对照组(n = 215)接受常规的基于讲座的教育项目,干预组(n = 209)接受修改后的患者教育项目。在入院时、出院时、出院后6个月和12个月对数据进行评估。主要结局是哮喘控制情况,次要结局是哮喘知识、生活质量和项目接受度。每次随访时通过协方差分析进行变化分析,并对基线值进行调整。

结果

两组在12个月时所有健康结局和哮喘控制情况均有统计学意义的显著改善:对照组:+1.9(95%可信区间1.3 - 2.6),干预组:+1.6(95%可信区间0.8 - 2.3)。我们观察到两组在哮喘控制和生活质量方面无显著差异。关于实用的哮喘知识,12个月后出现了组×时间交互作用,效应量较小(P = 0.06,η² = 0.01)。

结论

在哮喘控制方面,修改后的项目并不优于传统的患者教育。它能持续增加自我管理知识。

实际意义

结构化的行为患者教育可提高患者的疾病管理能力。需要探索改善哮喘控制的可能方法。

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