采用 PRISMS 表单提高 COPD 患者自我管理能力以改善护理质量：一项随机对照试验。

Improved quality of care by using the PRISMS form to support self-management in patients with COPD: A Randomised Controlled Trial.

机构信息

Department of University Healthcare Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

Centre for Clinical Research, RegionVärmland, Karlstad, Sweden.

出版信息

J Clin Nurs. 2020 Jul;29(13-14):2410-2419. doi: 10.1111/jocn.15253. Epub 2020 Apr 30.

DOI:10.1111/jocn.15253

PMID:32220091

Abstract

AIMS AND OBJECTIVE

To investigate the effects on the quality of care of the Patient Report Informing Self-Management Support (PRISMS) form compared with usual care among patients with chronic obstructive pulmonary disease (COPD) consulting a COPD nurse in primary health care.

BACKGROUND

Patients with COPD experience symptoms affecting their everyday lives, and there is a need for interventions in self-management support. The delivery of chronic care in an organised, structured and planned manner can lead to more productive relationships between professionals and patients.

DESIGN

A multicentre randomised controlled trial with a post-test design, according to the CONSORT checklist, in one intervention group (n = 94) and one control group (n = 108).

METHODS

In addition to usual care, the intervention group (n = 94) completed the PRISMS form to indicate areas where they wanted self-management support before the consultation with the COPD nurse. This form comprises 17 items that patients with COPD commonly experience as problems. The control group received usual care (n = 108). The primary outcome was patients' satisfaction with quality of care, assessed using the Quality from the Patient's Perspective (QPP) questionnaire. Means and (SD) are presented where applicable. Differences between the intervention and control group were analysed with Student's t test for independent groups for interval data, and the Mann-Whitney U test for ordinal data.

RESULTS

Participants in the intervention group were more satisfied with the QPP domains "personal attention," regarding both "perceived reality" (p = .021) and "subjective importance" (p = .012). The PRISMS form revealed "shortness of breath" as the most commonly experienced problem and the issue most desired to discuss.

CONCLUSION

The PRISMS form improved patient satisfaction with quality of care regarding personal attention, which is an important factor in patient participation and improving relationships and communication.

RELEVANCE TO CLINICAL PRACTICE

The PRISMS form can be a useful tool in improving person-centred care when delivering self-management support.

REGISTER ID

192691 at http://www.researchweb.org/is/en/sverige/project/192691.

摘要

目的和目标

调查在初级保健中为 COPD 患者提供护理时，与常规护理相比，患者报告自我管理支持（PRISMS）表格对护理质量的影响。

背景

COPD 患者会经历影响日常生活的症状，因此需要进行自我管理支持干预。以有组织、有结构和有计划的方式提供慢性病护理可以促进专业人员与患者之间更富有成效的关系。

设计

根据 CONSORT 清单，采用多中心随机对照试验和后测试设计，干预组（n=94）和对照组（n=108）各一组。

方法

除了常规护理外，干预组（n=94）在与 COPD 护士咨询之前填写 PRISMS 表格，以表明他们希望在自我管理支持方面得到支持的领域。该表格包含 17 个 COPD 患者常见的问题项目。对照组接受常规护理（n=108）。主要结局是使用患者从患者角度评估的护理质量（QPP）问卷评估患者对护理质量的满意度。适用时，报告平均值和（标准差）。采用独立样本 t 检验对区间数据和曼-惠特尼 U 检验对有序数据进行干预组和对照组之间的差异分析。