家庭护理治疗性对话对心力衰竭门诊患者健康相关生活质量、自我护理和抑郁的影响：一项随机多中心试验。
Effect of family nursing therapeutic conversations on health-related quality of life, self-care and depression among outpatients with heart failure: A randomized multi-centre trial.
机构信息
Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark.
Nursing Science & Care Ltd, Winterthur Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Switzerland.
出版信息
Patient Educ Couns. 2018 Aug;101(8):1385-1393. doi: 10.1016/j.pec.2018.03.006. Epub 2018 Mar 7.
OBJECTIVE
To evaluate the short-term (3 months) effects of family nursing therapeutic conversations (FNTC) on health-related quality of life, self-care and depression in outpatients with Heart failure (HF).
METHODS
A randomised multi-centre trial was conducted in three Danish HF clinics. The control group (n = 167) received usual care, and the intervention group (n = 180) received FNTCs as supplement to usual care. Primary outcome was clinically significant changes (6 points) in Kansas City Cardiomyopathy Questionnaire (KCCQ) summary score between groups. Secondary outcomes were changes in self-care behaviour and depression scores. Data were assessed before first consultation and repeated after three months.
RESULTS
No statistically significant difference was found in the change of KCCQ, self-care and depression scores between the groups. KCCQ scores of patients in the FNTC group changed clinically significant in seven domains, compared to one domain in the control group, with the highest improvement in self-efficacy, social limitation and symptom burden.
CONCLUSION
FNTC was not superior to standard care of patients with HF regarding health-related quality of life, self-care and depression.
IMPLICATION FOR PRACTICE
Addressing the impact of the disease on the family, might improve self-efficacy, social limitation and symptom burden in patients with heart failure.
目的
评估家庭护理治疗性对话（FNTC）对心力衰竭（HF）门诊患者健康相关生活质量、自我护理和抑郁的短期（3 个月）影响。
方法
在丹麦的三个 HF 诊所进行了一项随机多中心试验。对照组（n=167）接受常规护理，干预组（n=180）在常规护理的基础上接受 FNTC。主要结局是两组间堪萨斯城心肌病问卷（KCCQ）综合评分的临床显著变化（6 分）。次要结局为自我护理行为和抑郁评分的变化。数据在首次就诊前评估，并在三个月后重复评估。
结果
两组间 KCCQ、自我护理和抑郁评分的变化无统计学差异。与对照组的一个领域相比，FNTC 组患者的 KCCQ 评分在七个领域发生了临床显著变化，其中自我效能、社会限制和症状负担的改善最大。
结论
FNTC 在改善 HF 患者的健康相关生活质量、自我护理和抑郁方面并不优于标准护理。
实践意义
解决疾病对家庭的影响，可能会改善心力衰竭患者的自我效能、社会限制和症状负担。
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