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“没有恶化”:一项对心力衰竭患者治疗目标认知的定性研究。

"Not getting worse" a qualitative study of patients perceptions of treatment goals in patients with heart failure.

机构信息

Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands.

Department of Epidemiology, University Medical Center Groningen, University of Groningen, The Netherlands.

出版信息

Appl Nurs Res. 2018 Feb;39:41-45. doi: 10.1016/j.apnr.2017.10.010. Epub 2017 Oct 16.

Abstract

BACKGROUND

Knowledge of patient reported outcomes helps to provide personalized care on a patient level, optimize care on a population level, and identify the most appropriate patient reported outcomes for clinical trials. To be able to provide personalized care to patients with HF, it is important to know which treatment goals patients with HF consider the most important. This is particularly useful for interventions aimed at improving symptoms, functional status, or health-related quality of life.

AIM

The aim of this study was (1) to explore which treatment goals patients with heart failure (HF) perceive as important for their treatment and (2) to identify which treatment goals take priority over other treatment goals.

METHODS

The study had a qualitative design and included one focus group interview with 6 patients with HF. Data were analyzed using qualitative content analysis.

RESULTS

The overall theme of this study was found to be 'Not getting worse'. This theme was composed of 4 categories that described how the patients perceived the goals of treatment: to decrease symptoms, to improve physical function, to prevent readmission, and to live a normal life. None of the participants mentioned improved survival or being cured of their HF as a treatment goal.

CONCLUSION

'Not getting worse' was perceived as the treatment goal that matters to patients with HF and is in line with currently used endpoints for the evaluation of a treatment in a clinical trial. More research is necessary to develop endpoints that are consistent with the perception of patients, useful for clinical practice, and measurable.

摘要

背景

了解患者报告的结果有助于在患者层面提供个性化护理,优化人群层面的护理,并确定临床试验中最合适的患者报告结果。为了能够为心力衰竭(HF)患者提供个性化护理,了解 HF 患者认为哪些治疗目标最重要是很重要的。这对于旨在改善症状、功能状态或健康相关生活质量的干预措施尤其有用。

目的

本研究的目的是(1)探讨心力衰竭患者认为哪些治疗目标对其治疗重要,以及(2)确定哪些治疗目标优先于其他治疗目标。

方法

该研究采用定性设计,包括对 6 名心力衰竭患者进行一次焦点小组访谈。使用定性内容分析对数据进行分析。

结果

本研究的总体主题是“病情不恶化”。这一主题由描述患者如何看待治疗目标的 4 个类别组成:减轻症状、改善身体功能、预防再入院和过正常生活。没有参与者提到改善生存或治愈心力衰竭作为治疗目标。

结论

“病情不恶化”被认为是心力衰竭患者关心的治疗目标,与目前临床试验中用于评估治疗效果的终点一致。需要进一步研究以开发与患者的认知一致、对临床实践有用且可衡量的终点。

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