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个性化患者教育方法对心力衰竭自我管理的影响。

The Effect of a Personalized Approach to Patient Education on Heart Failure Self-Management.

作者信息

Athar Muhammad W, Record Janet D, Martire Carol, Hellmann David B, Ziegelstein Roy C

机构信息

Division of Cardiovascular Health and Diseases, University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML 0542, Cincinnati, OH 45267-0542, USA.

Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, MFL building East Tower, 2nd floor, Baltimore, MD 21224, USA.

出版信息

J Pers Med. 2018 Nov 27;8(4):39. doi: 10.3390/jpm8040039.

Abstract

Personalized tools relevant to an individual patient's unique characteristics may be an important component of personalized health care. We randomized 97 patients hospitalized with acute decompensated heart failure to receive a printout of an ultrasound image of their inferior vena cava (IVC) with an explanation of how the image is related to their fluid status ( = 50) or to receive no image and only generic heart failure information ( = 47). Adherence to medications, low-sodium diet, and daily weight measurement at baseline and 30 days after discharge were assessed using the Medical Outcomes Study Specific Adherence Scale, modified to a three-item version for heart failure (HF), (MOSSAS-3HF, maximum score = 15, indicating adherence all of the time). The baseline MOSSAS-3HF scores (mean ± standard deviation (SD)) were similar for intervention and control groups (7.4 ± 3.4 vs. 6.4 ± 3.7, = 0.91). The MOSSAS-3HF scores improved for both groups but were not different at 30 days (11.8 ± 2.8 vs. 11.7 ± 3.0, = 0.90). Survival without readmission or emergency department (ED) visit at 30 days was similar (82.6% vs. 84.1%, = 0.85). A personalized HF tool did not affect rates of self-reported HF treatment adherence or survival without readmission or ED visit.

摘要

与个体患者独特特征相关的个性化工具可能是个性化医疗保健的一个重要组成部分。我们将97例因急性失代偿性心力衰竭住院的患者随机分组,其中50例患者接受下腔静脉(IVC)超声图像打印件及关于该图像与他们的液体状态如何相关的解释,另外47例患者不接受图像,仅获得一般性心力衰竭信息。使用医学结局研究特定依从性量表评估出院时和出院后30天的药物依从性、低钠饮食和每日体重测量情况,该量表已修改为针对心力衰竭(HF)的三项版本(MOSSAS - 3HF,最高分 = 15分,表示始终依从)。干预组和对照组的基线MOSSAS - 3HF评分(均值±标准差(SD))相似(7.4±3.4对6.4±3.7,P = 0.91)。两组的MOSSAS - 3HF评分均有所改善,但在30天时无差异(11.8±2.8对11.7±3.0,P = 0.90)。30天时无再次入院或急诊就诊的生存率相似(82.6%对84.1%,P = 0.85)。个性化心力衰竭工具并未影响自我报告的心力衰竭治疗依从率或无再次入院或急诊就诊的生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95a7/6313701/297717a7a839/jpm-08-00039-g001.jpg

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