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出院后随访对烧伤患者健康状况的影响:一项随机临床试验。

Effect of Post-Hospital Discharge Follow-up on Health Status in Patients with Burn Injuries: A Randomized Clinical Trial.

作者信息

Heydarikhayat Nastaran, Ashktorab Tahereh, Rohani Camelia, Zayeri Farid

机构信息

Student Research Committee, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Int J Community Based Nurs Midwifery. 2018 Oct;6(4):293-304.

Abstract

BACKGROUND

Patients with burn injuries still face various burn-related challenges after being discharged from the hospital. Hence, a follow-up program for such patients is essential. The present study aimed to evaluate the health status of burn victims after 1.5 months follow-up.

METHODS

The present randomized clinical trial was of a pretest-posttest design, carried out in Kermanshah (Iran) from July 2016 to September 2017. A total of 117 participants were recruited out of which 86 were included in the analysis. The participants were randomly assigned into two groups, namely the intervention group (N=42) and the control group (N=44). All participants were evaluated both at the time of hospital discharge and at 1.5 months post-discharge. The follow-up plan for the intervention group included home visits, telenursing, and referral to specialists or health education centers. To evaluate the physical and psychological status of the participants, five different instruments were used; namely the Burn Specific Health Scale-Brief (BSHS-B), the General Health Questionnaire-28 (GHQ-28), the Brief Pain Inventory (BPI), the Vancouver Scar Scale (VSS), and the Visual Analogue Scale (VAS). All statistical analyses were performed using the SPSS software (version 17.0). Data were analyzed using the Chi-square test, independent t-test, and paired t-test. P<0.05 was considered statistically significant.

RESULTS

The mean score of the BSHS-B questionnaire at both the time of discharge and 1.5 months post-discharge follow-up for the control and intervention groups was 61.22±19.07, 57.14±18.92; 83.70±24.73 and 105.16±29.17, respectively. There was a significant difference between the groups at 1.5 months post-discharge follow-up (P<0.001). At 1.5 months, the VSS score was 5.16±1.68 and 6.77±3.46 for the intervention and control groups, respectively. The GHQ-28 score was 28.69±12.39 and 40.79±16.20 for the intervention and control groups, respectively. The VAS and BPI scores of the control group were 5.56±3.11 and 21.93±29.25, respectively. For the intervention group, these scores were 4.85±3.49 and 15.61±27.47, respectively. There was a significant difference between the groups as to the GHQ and VSS scores (P<0.05). However, no significant difference was noted in the BPI and VAS scores (P<0.05).

CONCLUSION

Health status, psychological status, and scar management were improved due to post-discharge follow-up. However, burn patients required continued care for pain, psychological health, and itching problems. IRCT2016110630712N.

摘要

背景

烧伤患者出院后仍面临各种与烧伤相关的挑战。因此,为这类患者开展随访计划至关重要。本研究旨在评估烧伤患者在1.5个月随访后的健康状况。

方法

本随机临床试验采用前测-后测设计,于2016年7月至2017年9月在克尔曼沙赫(伊朗)进行。共招募了117名参与者,其中86名纳入分析。参与者被随机分为两组,即干预组(N = 42)和对照组(N = 44)。所有参与者在出院时和出院后1.5个月均接受评估。干预组的随访计划包括家访、远程护理以及转介至专科医生或健康教育中心。为评估参与者的身体和心理状况,使用了五种不同的工具;即简明烧伤特异性健康量表(BSHS-B)、一般健康问卷-28(GHQ-28)、简明疼痛问卷(BPI)、温哥华瘢痕量表(VSS)和视觉模拟量表(VAS)。所有统计分析均使用SPSS软件(版本17.0)进行。数据采用卡方检验、独立t检验和配对t检验进行分析。P<0.05被认为具有统计学意义。

结果

对照组和干预组在出院时及出院后1.5个月随访时的BSHS-B问卷平均得分分别为61.22±19.07、57.14±18.92;83.70±24.73和105.16±29.17。出院后1.5个月随访时两组之间存在显著差异(P<0.001)。在1.5个月时,干预组和对照组的VSS得分分别为5.16±1.68和6.77±3.46。干预组和对照组的GHQ-28得分分别为28.69±12.39和40.79±16.20。对照组的VAS和BPI得分分别为5.56±3.11和21.93±29.25。干预组的这些得分分别为4.85±3.49和15.61±27.47。两组在GHQ和VSS得分方面存在显著差异(P<0.05)。然而,BPI和VAS得分方面未观察到显著差异(P<0.05)。

结论

出院后随访改善了健康状况、心理状况和瘢痕管理。然而,烧伤患者在疼痛、心理健康和瘙痒问题方面仍需要持续护理。IRCT2016110630712N。

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