Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
Intensive Care Units, Landspitali - The National University Hospital 101 Reykjavik, Iceland.
J Adv Nurs. 2018 Mar;74(3):709-723. doi: 10.1111/jan.13485. Epub 2017 Dec 5.
The aim of this study was to describe a structured 3-month nurse-led follow-up of patients after discharge from intensive care and measure its effects on health status.
Patients requiring intensive care stay frequently have lengthy and incomplete recovery suggesting need for additional support. The effects of intensive care nurse-led follow-up have not been sufficiently elucidated.
A prospective, quasi-experimental study of patients who received structured nurse-led follow-up from intensive care nurses after discharge from intensive care until 3 months afterwards. The control group received usual care.
Of 574 patients assessed for eligibility, from November 2012 - May 2015, 168 were assigned to the experimental group (N = 73) and the control group (N = 75). Primary outcome was health status, measured with eight scales of Short Form-36v2, before the intensive care admission and at four time points until 12 months after intensive care. A mixed effect model tested differences between the groups over time. Criteria for Reporting Development and Evaluation of Complex Interventions 2 guideline, guided the reporting of the intervention.
The structured nurse-led follow-up did not improve patients' health status compared with usual care (mixed effect model, p = .078-.937).
The structured nurse-led follow-up did not reveal an effect on the intensive care patients studied. Further examination of intensive care nurse-led follow-up is needed, taking into account the heterogeneity of the patient population, variations in length of ward stay, patients' health care needs during the first week at home after discharge from general ward and health status before intensive care admission.
本研究旨在描述对重症监护病房出院患者进行 3 个月的护士主导随访，并评估其对健康状况的影响。
需要入住重症监护病房的患者通常需要长时间且不完全的康复，这表明他们需要额外的支持。重症监护病房护士主导的随访效果尚未得到充分阐明。
一项前瞻性、准实验研究，对从重症监护病房出院后至 3 个月期间接受重症监护病房护士进行结构化护士主导随访的患者进行研究。对照组接受常规护理。
在 2012 年 11 月至 2015 年 5 月期间，对 574 名符合条件的患者进行评估，其中 168 名患者被分配到实验组（N=73）和对照组（N=75）。主要结局是健康状况，采用健康调查简表 36 项版本 2（SF-36v2）的 8 个量表进行测量，在入住重症监护病房之前和重症监护病房之后的 4 个时间点进行测量，直到重症监护病房后 12 个月。混合效应模型测试了两组在不同时间点的差异。复杂干预措施的开发和评估报告标准 2 指南指导了干预措施的报告。
与常规护理相比，结构化护士主导的随访并未改善患者的健康状况（混合效应模型，p=0.078-0.937）。
在本研究中，结构化护士主导的随访并未显示对重症监护患者有影响。需要进一步研究重症监护病房护士主导的随访，考虑到患者人群的异质性、病房停留时间的变化、患者出院后第一周在家中的医疗保健需求以及入住重症监护病房前的健康状况。
