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评估关于管理充血性心力衰竭症状的知识:患者与专业人员得分的差异。

Assessing Knowledge Regarding Managing Congestive Health Failure Symptoms: Differences in Patient and Professional Scores.

作者信息

Berrios-Thomas Saskia, Engel Rafael, McCall Janice, Rosen Daniel

机构信息

School of Social Work, University of Pittsburgh, Pittsburgh, PA, USA.

Department of Social Work, Carlow University, Pittsburgh, PA, USA. Ms. Berrios-Thomas is now at the School of Social Work, University of Michigan.

出版信息

J Patient Exp. 2018 Dec;5(4):289-295. doi: 10.1177/2374373518765793. Epub 2018 Apr 4.

Abstract

OBJECTIVE

To assess whether patients with congestive heart failure (CHF) and health coaches agree about patient knowledge of health-enhancing practices related to CHF after ongoing telehealth coaching.

METHODS

Forty patients with CHF and eligible for both Medicare and Medicaid were recruited from a regional managed care organization for this pilot study. Telecoaching sessions via a health insurance portability and accountability act(HIPAA)-compliant tablet-based platform focused on educational information designed to improve patient self-care. Social workers administered the 13-item Member Confidence Measure at baseline and at 30 and 180 days into the intervention. Patients and social workers provided separate ratings.

RESULTS

As expected at baseline, patient and coach scores differed, with patients reporting higher perceived knowledge scores ( < .01). Contrary to expectation, patient and coach scores did not converge at 30 and 180 days. Patient scores continued to increase at 30 and 180 days, while coaches' scores increased at 30 days, but not at 180 days.

CONCLUSION

Overall, patients continued to overrate their understanding about CHF. A telecoaching platform provides an opportunity to enhance patient's knowledge of their chronic disease and for patients to sustain that knowledge over time.

PRACTICE IMPLICATIONS

Addressing a patient's misperception of their knowledge to manage a chronic disease is critical for enhancing well-being. Coaches' scores did increase at 30 days suggesting that telecoaching is effective, but more monitoring may be required to ensure that these gains persist over time.

摘要

目的

评估充血性心力衰竭(CHF)患者与健康教练在持续的远程健康指导后,对于患者对CHF相关健康促进措施的了解程度是否达成一致。

方法

从一个地区性管理式医疗组织招募了40名符合医疗保险和医疗补助条件的CHF患者参与这项试点研究。通过一个符合健康保险流通与责任法案(HIPAA)的基于平板电脑的平台进行远程指导课程,重点是旨在改善患者自我护理的教育信息。社会工作者在基线时以及干预开始后的30天和180天进行13项成员信心测量。患者和社会工作者分别给出评分。

结果

正如基线时所预期的,患者和教练的评分存在差异,患者报告的感知知识评分更高(P<0.01)。与预期相反,患者和教练的评分在30天和180天时并未趋同。患者评分在30天和180天时持续增加,而教练评分在30天时增加,但在180天时未增加。

结论

总体而言,患者继续高估他们对CHF的理解。远程指导平台为增强患者对其慢性病的了解以及使患者长期维持该知识提供了机会。

实践意义

解决患者对其管理慢性病知识的误解对于提高幸福感至关重要。教练评分在30天时确实有所增加,表明远程指导是有效的,但可能需要更多监测以确保这些进展能长期持续。

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