Mo Yuzhu, Wang Haiyan, Huang Guoding, Chu Mingzi
Department of Nursing, Hainan Western Central Hospital, Hainan.
Department of Nursing, the Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai.
Medicine (Baltimore). 2020 Aug 14;99(33):e21746. doi: 10.1097/MD.0000000000021746.
Current study was to evaluate the effectiveness of nurse-led program in improving mental health status (MHS) and quality of life (QOL) in chronic heart failure (CHF) patients after an acute exacerbation. CHF patients were enrolled after informed consent was obtained and were assigned into the control and treatment group. Patients in the control group received standard care. In the treatment group, patients received standard care plus telehealth intervention including inquiring patients medical condition, providing feedbacks, counseling patients, and having positive and emotional talk with patients. At the third and sixth month after discharge, participants were called by registered nurses to assess Mental Health Inventory-5 (MHI-5) and Kansas City Cardiomyopathy Questionnaire (KCCQ) scores. Compared to the treatment group, patients in the control group were less likely to have educational attainment ≥ high school degree and have a married status, but were more likely to have diabetes. No significant differences in MHI-5 (68.5 ± 12.7 vs 66.9 ± 10.4) and KCCQ (70.6 ± 12.2 vs 68.7 ± 10.9) scores at baseline between the control and treatment groups were observed. There were significantly differences in MHI-5 (72.7 ± 15.6 vs 65.2 ± 11.4) and KCCQ score (74.2 ± 14.9 vs 66.4 ± 12.1) at 3 months follow-up between control and treatment groups. Nonetheless, at 6 months follow-up, although MHI-5 and KCCQ scores remained higher in the treatment group, there were no statistically significant differences (MHI-5: 65.4 ± 12.8 vs 61.4 ± 10.0; KCCQ: 65.1 ± 12.3 vs 61.9 ± 10.3). After multivariate regression analysis, not receiving nurse-led program were significantly associated with reduced MHI-5 (odds ratio [OR] 1.25% and 95% confidence interval [CI]: 1.14-1.60) and KCCQ (OR: 1.20% and 95% CI:1.11-1.54) scores. Nurse-led program is helpful to improve MHS and QOL in CHF patients after an acute exacerbation. However, these achievements are attenuated quickly after the nurse-led intervention discontinuation.
本研究旨在评估由护士主导的项目对改善慢性心力衰竭（CHF）患者急性加重后心理健康状况（MHS）和生活质量（QOL）的有效性。在获得知情同意后，纳入CHF患者，并将其分为对照组和治疗组。对照组患者接受标准护理。治疗组患者在接受标准护理的基础上，还接受远程医疗干预，包括询问患者病情、提供反馈、为患者提供咨询以及与患者进行积极的情感交流。在出院后的第三个月和第六个月，由注册护士致电参与者，评估其心理健康量表-5（MHI-5）和堪萨斯城心肌病问卷（KCCQ）得分。与治疗组相比，对照组患者获得高中及以上学历和已婚的可能性较小，但患糖尿病的可能性较大。对照组和治疗组在基线时的MHI-5（68.5±12.7 vs 66.9±10.4）和KCCQ（70.6±12.2 vs 68.7±10.9）得分无显著差异。在3个月随访时，对照组和治疗组的MHI-5（72.7±15.6 vs 65.2±11.4）和KCCQ得分（74.2±14.9 vs 66.4±12.1）存在显著差异。然而，在6个月随访时，尽管治疗组的MHI-5和KCCQ得分仍然较高，但无统计学显著差异（MHI-5：65.4±12.8 vs 61.4±10.0；KCCQ：65.1±12.3 vs 61.9±10.3）。多因素回归分析后，未接受护士主导项目与MHI-5得分降低（优势比[OR]1.25%，95%置信区间[CI]：1.14 - 1.60）和KCCQ得分降低（OR：1.20%，95%CI：1.11 - 1.54）显著相关。护士主导的项目有助于改善CHF患者急性加重后的MHS和QOL。然而，在护士主导的干预停止后，这些成果很快就会减弱。
