Björkman Ida, Ringström Gisela, Simrén Magnus, Myrgren Jenny, Jakobsson Ung Eva
Ida Björkman, PhD, RN, is Senior Lecturer, Institute of Health and Care Sciences and the Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Gisela Ringström, PhD, RN, is Head Nurse, Department of Internal Medicine & Clinical Nutrition, Institute of Medicine and the Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Magnus Simrén, PhD, MD, is Professor, Department of Internal Medicine & Clinical Nutrition, Institute of Medicine and the Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Jenny Myrgren, MSc, RN, is Nurse, Institute of Health and Care Sciences and the Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Eva Jakobsson Ung, PhD, RN, is Professor, Institute of Health and Care Sciences and the Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Gastroenterol Nurs. 2019 Jul/Aug;42(4):332-341. doi: 10.1097/SGA.0000000000000378.
Irritable bowel syndrome is a common and often chronic functional bowel disorder that can cause severe disruption of daily functioning in those affected, with subsequent high healthcare utilization and work absenteeism. Nurses represent an underutilized group in the current management of irritable bowel syndrome. The aim of this study was to systematically develop a person-centered support intervention in irritable bowel syndrome and evaluate this in a pilot study. The development followed the revised framework for complex interventions from the Medical Research Council and involved literature reviews and multiprofessional expert groups. The intervention was then tested in a pilot study including 17 patients and evaluated through validated questionnaires measuring irritable bowel syndrome symptom severity, gastrointestinal-specific anxiety, and self-efficacy as well as through interviews. There was a significant improvement in irritable bowel syndrome symptom severity between baseline and follow-up, but not for self-efficacy or gastrointestinal-specific anxiety. The patients' perceptions of participating in the intervention were positive and induced a learning process; they were able to form a supportive relationship with the nurse and their ability to self-manage improved. The promising results from this small pilot study in terms of feasibility, potential efficacy, and the patients' positive feedback make this intervention a suitable candidate for a larger controlled trial.
肠易激综合征是一种常见且往往为慢性的功能性肠病,可严重干扰患者的日常功能,导致随后较高的医疗资源利用和工作缺勤率。在当前肠易激综合征的管理中,护士是一个未得到充分利用的群体。本研究的目的是系统地开发一种以患者为中心的肠易激综合征支持干预措施,并在一项试点研究中对其进行评估。该开发遵循了医学研究理事会修订后的复杂干预框架,涉及文献综述和多专业专家小组。然后在一项包括17名患者的试点研究中对该干预措施进行测试,并通过测量肠易激综合征症状严重程度、胃肠道特异性焦虑和自我效能感的有效问卷以及访谈进行评估。基线和随访之间肠易激综合征症状严重程度有显著改善,但自我效能感或胃肠道特异性焦虑没有改善。患者对参与干预的看法是积极的,并引发了一个学习过程;他们能够与护士建立支持性的关系,自我管理能力也有所提高。这项小型试点研究在可行性、潜在疗效和患者积极反馈方面取得的有前景的结果,使该干预措施成为一项更大规模对照试验的合适候选方案。