Department of Nursing, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Immunology and Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Asian Nurs Res (Korean Soc Nurs Sci). 2019 May;13(2):107-114. doi: 10.1016/j.anr.2019.02.004. Epub 2019 Mar 4.
The purpose of this study is to investigate the impact of transitional care by a nurse-led multidisciplinary team (MDT) on clinical outcomes and quality of life of patients with ankylosing spondylitis.
A randomized control study design was used. Subjects were allocated randomly to an experimental group and a control group. The experimental group received intensive transitional care by a nurse-led MDT, whereas the control group received routine nursing care. Disease activity, spinal mobility, comprehensive function, health service utilization, and quality of life were assessed at the baseline and at six months with the Bath Ankylosing Spondylitis Metrology Index, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), a health service utilization questionnaire and version 2 of the Short Form-36 health survey.
Compared with the baseline, the BASDAI, BASFI, emergency visits, hospitalizations, hospitalization days, and bodily pain, vitality, mental health, total score, and average score of version 2 of the Short Form-36 health survey were improved in the experimental group (p < .05), whereas only bodily pain, vitality, and role-emotional were improved in the control group (p < .05). At six months, the experimental group exhibited significantly more improvement on the BASDAI, BASFI, hospitalizations, all domains except Role-physical as well as total score and average score (p < .05) compared with the control group.
A MDT-based nurse-led transitional care improves clinical outcomes and quality of life of patients with ankylosing spondylitis. Future research should be carried out on modes of follow-up and family support.
本研究旨在探讨由护士主导的多学科团队(MDT)进行过渡护理对强直性脊柱炎患者临床结局和生活质量的影响。
采用随机对照研究设计。将受试者随机分配到实验组和对照组。实验组接受护士主导的 MDT 强化过渡护理,而对照组接受常规护理。在基线和 6 个月时使用 Bath 强直性脊柱炎计量指数、Bath 强直性脊柱炎疾病活动指数(BASDAI)、Bath 强直性脊柱炎功能指数(BASFI)、健康服务利用问卷和简短表单-36 健康调查第 2 版评估疾病活动度、脊柱活动度、综合功能、健康服务利用和生活质量。
与基线相比,实验组的 BASDAI、BASFI、急诊就诊、住院、住院天数和身体疼痛、活力、心理健康、简短表单-36 健康调查第 2 版总分和平均分均有所改善(p<.05),而对照组仅身体疼痛、活力和角色情绪有所改善(p<.05)。在 6 个月时,实验组在 BASDAI、BASFI、住院、除角色身体外的所有领域以及总分和平均分方面的改善均明显优于对照组(p<.05)。
基于 MDT 的护士主导的过渡护理可改善强直性脊柱炎患者的临床结局和生活质量。未来的研究应着眼于随访和家庭支持模式。