Davis Leslie L, McCoy Thomas P
Leslie L. Davis, PhD, RN, ANP-BC, FAANP, FAHA, is an associate professor of nursing at the School of Nursing, University of North Carolina, Greensboro. Dr Davis is a board certified adult nurse practitioner and has clinical expertise in hypertension, heart failure, and coronary artery disease. Her program of research focuses on self-care related to symptom monitoring and symptom management of cardiovascular conditions. Thomas P. McCoy, PhD, PStat, is a statistician and clinical associate professor at the School of Nursing, University of North Carolina, Greensboro. Dr McCoy has a PhD in Educational Research, Measurement, and Evaluation. He is also an Accredited Professional Statistician by the American Statistical Association. His research interests are biostatistics and psychometrics.
Dimens Crit Care Nurs. 2019 Jan/Feb;38(1):29-37. doi: 10.1097/DCC.0000000000000329.
The type of symptoms that a woman experiences during an acute coronary syndrome (ACS) event influences symptom recognition and interpretation. Women who experience intense, abrupt symptoms are more likely to correctly attribute symptoms to a cardiac etiology and seek care faster than women with less intense, intermittent symptoms.
A single-group pretest-posttest design was used to evaluate the feasibility and acceptability of a nurse-delivered education and skill-building intervention designed to improve symptom recognition and interpretation in women with recurrent ACS symptoms.
Women hospitalized for an ACS event received an individualized education and skill-building intervention that was conceptually framed by the investigator's previous research. Three in-person sessions were followed by 2 telephone sessions for reinforcement. Outcomes and acceptability were evaluated at close-out (approximately 2 months after the index event).
All but 2 women approached agreed to participate. Of the 10 women enrolled, 9 completed all study sessions within an average of 55 days. Mean knowledge scores increased by 7.4% measured by the ACS Response Index. Attitudes toward symptom recognition and help seeking increased by 2.4, whereas beliefs toward expectations and actions increased by 3.2. The women were pleased with the intervention (satisfaction scores averaging 1.4 on a 4-point Likert scale, with 1 as "strongly agree" and 4 as "strongly disagree"). All women who completed the study would recommend it to others.
The nurse-delivered intervention was feasible and acceptable to women in the study. Results support further testing and refinement of the intervention in a longitudinal randomized control study to determine efficacy and sustainability.
女性在急性冠状动脉综合征(ACS)发作期间经历的症状类型会影响症状的识别和判断。与症状较轻、断断续续的女性相比,经历强烈、突发症状的女性更有可能正确地将症状归因于心脏病因,并更快地寻求治疗。
采用单组前后测设计,评估由护士提供的教育和技能培养干预措施的可行性和可接受性,该干预旨在提高有复发性ACS症状女性的症状识别和判断能力。
因ACS事件住院的女性接受了个性化的教育和技能培养干预,该干预在概念上基于研究者之前的研究。进行了三次面对面授课,随后通过两次电话授课进行强化。在结束时(约在索引事件发生后2个月)评估结果和可接受性。
除2名女性外,其他所有被邀请的女性均同意参与。在招募的10名女性中,9名在平均55天内完成了所有研究课程。通过ACS反应指数测量,平均知识得分提高了7.4%。对症状识别和寻求帮助的态度提高了2.4,而对期望和行动的信念提高了3.2。这些女性对干预措施感到满意(在4分制李克特量表上满意度得分平均为1.4,1表示“强烈同意”,4表示“强烈不同意”)。所有完成研究的女性都会向他人推荐该研究。
护士提供的干预措施对研究中的女性来说是可行且可接受的。结果支持在纵向随机对照研究中对该干预措施进行进一步测试和完善,以确定其有效性和可持续性。