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《严重精神障碍患者健康改善特征量表中文版:一项集群随机对照试验》

Chinese Health Improvement Profile for people with severe mental illness: A cluster-randomized, controlled trial.

机构信息

School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.

Castle Peak and Siu Lam Hospitals, Hong Kong, Hong Kong.

出版信息

Int J Ment Health Nurs. 2018 Apr;27(2):841-855. doi: 10.1111/inm.12373. Epub 2017 Aug 7.

Abstract

The aim of the present study was to establish the feasibility of conducting a full-scale trial and to estimate the preliminary effect of a Chinese Health Improvement Profile (CHIP) intervention on self-reported physical well-being of people with severe mental illness (SMI). The study used a parallel-group, open-label, cluster-randomized, controlled trial (RCT) design. Twelve community psychiatric nurses (CPN) and their corresponding 137 patients with SMI were randomized into the CHIP or treatment-as-usual (TAU) groups. After training, the CPN completed the CHIP at baseline and 12 months, and the findings were used to devise an individualized care plan to promote health behaviour change. Patients were assessed at baseline and 6 and 12 months after starting the intervention. There was an observed positive trend of improvement on the physical component subscale of SF12v2 in the CHIP group compared to the TAU group after 12 months, but the difference did not reach statistical significance (P = 0.138). The mental component subscale showed a similar positive trend (P = 0.077). CHIP participants were more satisfied with their physical health care than TAU patients (P = 0.009), and the CPN were positive about the usefulness/acceptability of the intervention. There were significant within-group improvements in the total numbers of physical health risks, as indicated by the CHIP items (P = 0.005). The findings suggest that it is feasible to conduct a full-scale RCT of the CHIP in future. The CHIP is an intervention that can be used within routine CPN practice, and could result in small-modest improvements in the physical well-being of people with SMI.

摘要

本研究旨在确定开展全面试验的可行性,并评估中国健康改进概况(CHIP)干预对严重精神疾病(SMI)患者自我报告身体福祉的初步效果。该研究采用了平行组、开放标签、聚类随机对照试验(RCT)设计。12 名社区精神科护士(CPN)及其对应的 137 名 SMI 患者被随机分为 CHIP 或常规治疗(TAU)组。培训后,CPN 在基线和 12 个月时完成 CHIP,研究结果用于制定个性化的护理计划,以促进健康行为改变。患者在干预开始后 6 个月和 12 个月进行评估。与 TAU 组相比,CHIP 组在 12 个月后 SF12v2 的身体成分子量表上观察到改善的积极趋势,但差异无统计学意义(P=0.138)。心理成分子量表也显示出类似的积极趋势(P=0.077)。与 TAU 患者相比,CHIP 参与者对他们的身体健康护理更满意(P=0.009),CPN 对干预的有用性/可接受性持积极态度。CHIP 项目表明,身体健康风险的总数有显著的组内改善(P=0.005)。研究结果表明,未来开展 CHIP 的全面 RCT 是可行的。CHIP 是一种可以在常规 CPN 实践中使用的干预措施,可以使 SMI 患者的身体幸福感得到适度改善。

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