急性冠状动脉综合征事件后以人为本的护理效果：一项随机对照试验的两年随访。
Effects of person-centred care after an event of acute coronary syndrome: Two-year follow-up of a randomised controlled trial.
机构信息
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, Box 457, 405 30 Gothenburg, Sweden; Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden; Närhälsan Research and Development Primary Health Care, Region Västra Götaland, Sweden.
Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; National Heart and Lung Institute, Imperial College, London, United Kingdom.
出版信息
Int J Cardiol. 2017 Dec 15;249:42-47. doi: 10.1016/j.ijcard.2017.08.069. Epub 2017 Sep 6.
AIM
To assess the long-term effect of person-centred care (PCC) in patients with acute coronary syndrome (ACS).
METHOD
Patients with ACS were randomly assigned to treatment as usual (control group) or an added PCC intervention for six months. The primary endpoint was a composite score of changes in general self-efficacy≥five units, return to work or to a prior activity level and re-hospitalisation or death.
RESULTS
The composite score improved in the PCC intervention group (n=94) at a two-year follow-up compared with the control group (n=105) (18.1%, n=17 vs. 10.5%, n=11; P=0.127). In the per-protocol analysis (n=183) the improvement was significant in favour of the PCC intervention (n=78) compared with usual care (n=105) (21.8%, n=17 vs. 10.5%, n=11; P=0.039). This effect was driven by the finding that more patients in the PCC group improved their general self-efficacy score≥5units (32.2%, n=19 vs. 17.3%, n=14; P=0.046). The composite score improvement was significantly higher in the PCC intervention group without post-secondary education (n=33) in comparison with corresponding patients in the control group (n=50) (30.3%, n=10 vs. 10.0%, n=5; P=0.024).
CONCLUSION
Implementation of PCC results in sustained improvements in health outcome in patients with ACS. PCC can be incorporated into conventional cardiac prevention programmes to improve equity in uptake and patient health outcomes.
TRIAL REGISTRATION
Swedish registry, Researchweb.org, ID NR 65791.
目的
评估以患者为中心的护理（PCC）对急性冠状动脉综合征（ACS）患者的长期效果。
方法
将 ACS 患者随机分为常规治疗（对照组）或附加 PCC 干预治疗 6 个月。主要终点是一般自我效能感变化综合评分≥5 分、重返工作或之前的活动水平以及再住院或死亡。
结果
在两年随访时，PCC 干预组（n=94）的综合评分较对照组（n=105）有所改善（18.1%，n=17 例 vs. 10.5%，n=11 例；P=0.127）。在符合方案分析（n=183）中，PCC 干预（n=78）明显优于常规护理（n=105）（21.8%，n=17 例 vs. 10.5%，n=11 例；P=0.039）。这种效果是由发现 PCC 组有更多患者的一般自我效能感评分提高≥5 分（32.2%，n=19 例 vs. 17.3%，n=14 例；P=0.046）。在没有接受过高等教育的 PCC 干预组（n=33）中，复合评分的改善明显高于对照组（n=50）（30.3%，n=10 例 vs. 10.0%，n=5 例；P=0.024）。
结论
实施 PCC 可使 ACS 患者的健康结果持续改善。PCC 可以纳入常规心脏预防计划，以改善接受程度和患者健康结果的公平性。
试验注册
瑞典注册处，Researchweb.org，ID NR 65791。
Zotero 插件