基于头像的教育应用对改善心力衰竭患者知识和自我护理行为的效果：一项实用随机对照试验。
Effectiveness of an avatar educational application for improving heart failure patients' knowledge and self-care behaviors: A pragmatic randomized controlled trial.
机构信息
Department of Adult Nursing, Faculty of Nursing, Khon Kaen University, Thailand.
College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
出版信息
J Adv Nurs. 2020 Sep;76(9):2401-2415. doi: 10.1111/jan.14414. Epub 2020 Jul 27.
AIM
To evaluate the effectiveness of education using avatars for improving patients' heart failure knowledge and self-care.
BACKGROUND
A lack of knowledge and self-care contributes to poor outcomes and rehospitalization for people with heart failure.
DESIGN
A multi-centred, non-blinded pragmatic randomized controlled trial.
METHODS
Heart failure patients were randomly assigned to intervention (avatar education application) or usual care groups. Participants were followed up at baseline, 30 and 90 days. ANCOVA was used to compare the scores of heart failure knowledge and self-care, between the two groups. Fisher's exact test was used to compare the two groups' heart failure-cause readmission. Bivariate exact binary logistic regression was used to identify the predictors associated with baseline levels of knowledge.
RESULTS
A total of 36 participants were recruited (between October 2018 - March 2019). The mean age of participants was 67.5 (SD 11.3) years. At enrolment, approximately half (47.2%) have been living with Heart Failure for over 5 years. Two groups were comparable at baseline in their demographic and clinical characteristics. At 90 days, the intervention group participants had a higher increase in knowledge score on the Dutch Heart Failure Knowledge Scales compared with the control group (22.2% versus 3.7% P = .002, partial η = 0.262, 95% CI -2.755 to -0.686). There was no between-group difference observed at 30- or 90-day follow-up, on self-care behaviour (Self-care of heart failure index) or healthcare use. Overall satisfaction with the avatar app was 91.3%.
CONCLUSION
The addition of a co-designed avatar app to usual care improved knowledge in our group of Heart Failure participants at 30 days and continued to increase up to 90 days. The results suggest that our avatar app was perceived as an enjoyable and engaging means of delivering critical knowledge and self-care information.
IMPACT
Heart failure is associated with poor clinical outcomes (i.e., readmission rates and mortality rate) and substantial economic burden. The effectiveness of Heart Failure patient education using avatar have not been investigated previously. In this study, the avatar app improved knowledge and self-care behaviours. This innovation could be used at the bedside, at home by nurses, patients and families.
TRIAL REGISTRATION
Australian New Zealand Trial Registry ACTRN12617001403325.
目的
评估使用虚拟形象进行教育对改善心力衰竭患者知识和自我护理的效果。
背景
知识和自我护理的缺乏会导致心力衰竭患者预后不良和再次住院。
设计
多中心、非盲实用随机对照试验。
方法
心力衰竭患者随机分配至干预组（虚拟形象教育应用）或常规护理组。参与者在基线、30 天和 90 天进行随访。使用协方差分析（ANCOVA）比较两组心力衰竭知识和自我护理评分。使用 Fisher 确切检验比较两组心力衰竭病因再入院率。使用双变量精确二项逻辑回归分析确定与基线知识水平相关的预测因素。
结果
共招募了 36 名参与者（2018 年 10 月至 2019 年 3 月）。参与者的平均年龄为 67.5（SD 11.3）岁。入组时，约有一半（47.2%）患者心力衰竭病史超过 5 年。两组在人口统计学和临床特征方面在基线时具有可比性。在 90 天时，干预组参与者在荷兰心力衰竭知识量表上的知识得分增加幅度高于对照组（22.2%对 3.7%，P=.002，部分η²=0.262，95%CI-2.755 至-0.686）。在 30 天或 90 天随访时，自我护理行为（心力衰竭自我护理指数）或医疗保健使用方面，两组之间没有差异。对虚拟形象应用程序的总体满意度为 91.3%。
结论
在常规护理中增加经过共同设计的虚拟形象应用程序，可提高心力衰竭患者组在 30 天的知识水平，并持续增加至 90 天。结果表明，我们的虚拟形象应用程序被认为是一种有趣且引人入胜的方式，可以提供关键知识和自我护理信息。
影响
心力衰竭与不良临床结局（即再入院率和死亡率）和巨大的经济负担相关。之前尚未研究过使用虚拟形象对心力衰竭患者进行教育的效果。在这项研究中，虚拟形象应用程序提高了知识和自我护理行为。这种创新可以在床边、在家中由护士、患者和家属使用。
试验注册
澳大利亚和新西兰临床试验注册中心 ACTRN12617001403325。
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