反馈教学法对心力衰竭患者知识、行为表现、再入院率及生活质量的影响
The Effect of the Teach-Back Method on Knowledge, Performance, Readmission, and Quality of Life in Heart Failure Patients.
作者信息
Rahmani Ali, Vahedian-Azimi Amir, Sirati-Nir Masoud, Norouzadeh Reza, Rozdar Hamid, Sahebkar Amirhossein
机构信息
Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
出版信息
Cardiol Res Pract. 2020 Nov 23;2020:8897881. doi: 10.1155/2020/8897881. eCollection 2020.
BACKGROUND
Among chronic diseases, heart failure has always been a serious challenge imposing high costs on health systems and societies. Therefore, nurses should adopt new educational strategies to improve self-care behaviors and reduce the readmissions in heart failure patients. This study aimed to determine the effect of the teach-back method on knowledge, performance, readmission, and quality of life in these patients.
METHODS
This clinical trial was conducted in patients with heart failure ( = 70) hospitalized in the internal wards of the Baqiyatallah al-Azam Medical Center in Tehran (2019). Routine discharge educations were provided in control patients. Self-care topics were taught to the intervention groups by the teach-back method. A cardiac self-care questionnaire was used to assess the knowledge and practice of patients immediately after intervention and three months after patient discharge. Also, SF-36 was presented to each patient. Readmission(s) and quality of life were followed up by telephone interviews three months after patient discharge. Repeated measures analysis of variance and related post-hoc tests were performed for within-group comparisons before, immediately after, and 3 months after teach-back education. Wilks' lambda multivariate tests were conducted for simultaneous comparison of quality of life subscales between intervention and control groups. Also, logistic regressions were after controlling for baseline measures and confounders.
RESULTS
Findings showed significant improvement in the patients' knowledge and performance immediately after teach-back education, though this effect was slow in the long term after discharge. Also, the frequency of readmissions decreased and the quality of life (except physical function) increased in the patients through teach-back education. By controlling for the pretest effect, the posttest scores for the relevant components of the quality of life suggested improvement in both intervention and control patients. This improvement in the quality of life was confirmed by controlling for baseline measurements using binary logistic regression analysis.
CONCLUSION
Teach-back education improved patients' knowledge and performance, readmission frequency, and quality of life.
背景
在慢性疾病中，心力衰竭一直是一项严峻挑战，给卫生系统和社会带来高昂成本。因此，护士应采用新的教育策略来改善自我护理行为并减少心力衰竭患者的再入院率。本研究旨在确定反馈教学法对这些患者的知识、行为表现、再入院率和生活质量的影响。
方法
本临床试验于2019年在德黑兰巴奇亚塔拉·阿扎姆医疗中心内科病房住院的心力衰竭患者（n = 70）中进行。对照组患者接受常规出院教育。通过反馈教学法向干预组患者传授自我护理主题。使用心脏自我护理问卷在干预后即刻以及患者出院三个月后评估患者的知识和实践情况。此外，向每位患者发放SF-36量表。在患者出院三个月后通过电话访谈对再入院情况和生活质量进行随访。对反馈教学教育前、后即刻以及三个月后的组内比较进行重复测量方差分析及相关事后检验。对干预组和对照组之间的生活质量子量表进行Wilks' lambda多变量检验以进行同步比较。此外，在控制基线测量和混杂因素后进行逻辑回归分析。
结果
研究结果显示，反馈教学教育后即刻患者的知识和行为表现有显著改善，不过出院后的长期效果较为缓慢。此外，通过反馈教学教育患者的再入院频率降低，生活质量（身体功能除外）提高。通过控制预测试效应，生活质量相关组成部分的后测试分数表明干预组和对照组患者均有改善。使用二元逻辑回归分析控制基线测量后，生活质量的这种改善得到了证实。
结论
反馈教学教育改善了患者的知识、行为表现、再入院频率和生活质量。
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