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以患者为中心的护理对健康结局的影响——一项针对急性冠状动脉综合征患者的随机对照试验

Effects of person-centred care on health outcomes-A randomized controlled trial in patients with acute coronary syndrome.

作者信息

Pirhonen Laura, Olofsson Elisabeth Hansson, Fors Andreas, Ekman Inger, Bolin Kristian

机构信息

Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden; Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden; Centre for Health Economics (CHEGU), Department of Economics, University of Gothenburg, Sweden.

Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden; Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden.

出版信息

Health Policy. 2017 Feb;121(2):169-179. doi: 10.1016/j.healthpol.2016.12.003. Epub 2016 Dec 13.

Abstract

OBJECTIVES

To study the effects of person-centred care provided to patients with acute coronary syndrome, using four different health-related outcome measures. Also, to examine the performance of these outcomes when measuring person-centred care.

DATA AND METHOD

The data used in this study consists of primary data from a multicentre randomized parallel group, controlled intervention study for patients with acute coronary syndrome at Sahlgrenska University Hospital in Gothenburg, Sweden. The intervention and control group consisted of 94 and 105 patients, respectively. The effect of the intervention on health-related outcomes was estimated, controlling for socio-economic and disease-related variables.

RESULTS

Patients in the intervention group reported significantly higher general self-efficacy than those in the control group six months after intervention start-up. Moreover, the intervention group returned to work in a greater extent than controls; their physical activity level had increased more and they had a higher EQ-5D score, meaning higher health-related quality of life. These latter effects are not significant but are all pointing towards the beneficial effects of person-centred care. All the effects were estimated while controlling for important socio-economic and disease-related variables.

CONCLUSION

The effectiveness of person-centred care varies between different outcomes considered. A statistically significant beneficial effect was found for one of the four outcome measures (self-efficacy). The other measures all captured beneficial, but not significant, effects.

摘要

目的

使用四种不同的健康相关结局指标,研究以患者为中心的护理对急性冠脉综合征患者的影响。同时,考察这些结局指标在衡量以患者为中心的护理时的表现。

数据与方法

本研究使用的数据来自瑞典哥德堡萨尔格伦斯卡大学医院对急性冠脉综合征患者进行的一项多中心随机平行组对照干预研究的原始数据。干预组和对照组分别有94名和105名患者。在控制社会经济和疾病相关变量的情况下,评估干预对健康相关结局的影响。

结果

干预组患者在干预启动六个月后报告的总体自我效能感显著高于对照组。此外,干预组比对照组更大程度地恢复了工作;他们的身体活动水平提高得更多,并且EQ-5D得分更高,这意味着与健康相关的生活质量更高。后一种效果虽不显著,但都指向了以患者为中心的护理的有益效果。所有效果都是在控制重要的社会经济和疾病相关变量的情况下进行评估的。

结论

以患者为中心的护理的有效性在不同的结局指标之间存在差异。在四项结局指标之一(自我效能感)上发现了具有统计学意义的有益效果。其他指标均显示出有益效果,但不显著。

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