The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong.
Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Hong Kong.
J Adv Nurs. 2019 Dec;75(12):3740-3748. doi: 10.1111/jan.14162. Epub 2019 Aug 27.
This study aims to evaluate the effects of a 12-week empowerment-based self-care programme on the cognitive, psychological and behavioural aspects of self-care, health-related quality of life and unplanned hospital service use of chronic heart failure patients and to estimate its cost-effectiveness in reducing unplanned service use.
Randomized controlled trial with cost-effectiveness analysis.
The study will recruit 236 community-dwelling Chinese patients with chronic heart failure from regional hospitals in Hong Kong. Patients will be randomized in blocks to attend either the 12-week empowerment-based self-care programme or a didactic education programme. Central to the empowerment-based model is that the patients are the primary decision makers in self-care and act autonomously to manage the disease. Collaborative approach and interactive teaching strategies are used to optimize patients' engagement and knowledge translation to real-life practice. Outcome evaluation on self-care maintenance and management, symptom perception, self-care confidence, self-care knowledge, health-related quality of life and health service use will take place at baseline, on completion of the programme and at 12 weeks thereafter. Generalized estimating equations and Cox regression examine the intervention effects. Bootstrapping technique will be conducted to examine the cost-effectiveness of the intervention. The study is formally funded in December 2016.
Chronic heart failure is associated with high level of hospital admissions, of which 40% is avoidable through effective self-care. Although self-care confidence is known to improve self-care, no structured educative method has been developed to enhance this attribute. This study addresses this research gap with a stringent application of theory and research design.
The study illustrates the application of the empowerment model for self-care enhancement in patients with chronic heart failure. The findings will inform the ways and values of this care model to enhance the disease management of this expanding clinical cohort.
本研究旨在评估为期 12 周的基于赋权的自我护理计划对慢性心力衰竭患者自我护理的认知、心理和行为方面、健康相关生活质量和非计划性医院服务使用的影响，并估计其在减少非计划性服务使用方面的成本效益。
随机对照试验，结合成本效益分析。
本研究将从香港地区医院招募 236 名社区居住的慢性心力衰竭中国患者。患者将按块随机分配参加 12 周的基于赋权的自我护理计划或讲授式教育计划。基于赋权模式的核心是患者是自我护理的主要决策者，并自主管理疾病。采用协作方法和互动教学策略，以优化患者的参与度和知识转化为现实生活实践。在基线、计划完成时和之后的 12 周，将对自我护理维持和管理、症状感知、自我护理信心、自我护理知识、健康相关生活质量和卫生服务使用进行结果评估。广义估计方程和 Cox 回归检验干预效果。将采用自举技术检验干预的成本效益。该研究于 2016 年 12 月正式获得资助。
慢性心力衰竭与高住院率相关，其中 40%可以通过有效的自我护理来避免。尽管自我护理信心已知可以改善自我护理，但尚未开发出增强这种属性的结构化教育方法。本研究通过严格的理论和研究设计来解决这一研究差距。
本研究说明了赋权模型在增强慢性心力衰竭患者自我护理方面的应用。研究结果将为这种护理模式的应用方式和价值提供信息，以增强这一不断扩大的临床队列的疾病管理。
