Department of Nursing, Hainan Western Central Hospital, Hainan.
Department of Nursing, the Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
Medicine (Baltimore). 2021 Mar 12;100(10):e25052. doi: 10.1097/MD.0000000000025052.
The nurse-led program is associated with a short-term improvement of mental health status (MHS) and quality of life (QOL) in patients with chronic heart failure (CHF). Nonetheless, the long-term effect of this program is undetermined. The aims of the current study were to evaluate the 1-year effects of the nurse-led program on MHS, QOL, and heart failure (HF) rehospitalization among patients with CHF.CHF patients in the control group received standard care, and patients in the treatment group received standard care plus telehealth intervention including inquiring patients' medical condition, providing feedbacks, counseling and providing positive and emotional talk with the patients. At the third, sixth, and twelfth month's follow-up, patients were called by registered nurses to assess the Mental Health Inventory-5 (MHI-5) and Kansas City Cardiomyopathy Questionnaire (KCCQ) scores. HF rehospitalization was also assessed.A total of 300 patients were included and 46% (n = 138) of the patients were in the treatment group. There were no significant between-group differences in the MHI-5 and KCCQ scores at baseline. In the control group, the MHI-5 score was gradually decreased with follow-up and the score was significantly lower than that in the treatment group since the third month's follow-up (63.5 ± 10.6 vs 73.6 ± 10.3). Compared with the treatment group, KCCQ score was lower in the control group from the third month's follow-up (64.3 ± 10.6 vs 73.5 ± 12.3) until the end of the twelfth months' follow-up (45.3 ± 11.2 vs 60.8 ± 11.1). During 12 months' follow-up, the proportion of patients who experienced HF rehospitalization was lower in the treatment group (19.6% vs 24.1%). After adjusting for covariates, the utilization of the nurse-led program, and increase of MHI-5 and KCCQ scores were associated with reduced risk of HF rehospitalization.The nurse-led program is beneficial for the improvement of MHS and QOL for CHF patients, which might contribute to the reduction of HF rehospitalization.
该护士主导的项目与慢性心力衰竭（CHF）患者心理健康状况（MHS）和生活质量（QOL）的短期改善相关。然而，该项目的长期效果尚不确定。本研究的目的是评估该护士主导的项目对 CHF 患者 MHS、QOL 和心力衰竭（HF）再住院的 1 年影响。
对照组患者接受标准护理，治疗组患者接受标准护理加远程健康干预，包括询问患者病情、提供反馈、咨询以及与患者进行积极的情感交流。在第 3、6 和 12 个月的随访中，注册护士会评估患者的心理健康量表 5（MHI-5）和堪萨斯城心肌病问卷（KCCQ）评分。同时评估 HF 再住院情况。
共纳入 300 例患者，其中 46%（n=138）的患者在治疗组。两组患者在基线时 MHI-5 和 KCCQ 评分无显著差异。在对照组中，MHI-5 评分随随访逐渐下降，且自第 3 个月随访开始显著低于治疗组（63.5±10.6 与 73.6±10.3）。与治疗组相比，对照组从第 3 个月随访开始 KCCQ 评分较低（64.3±10.6 与 73.5±12.3），直至第 12 个月随访结束（45.3±11.2 与 60.8±11.1）。在 12 个月的随访期间，治疗组 HF 再住院的患者比例较低（19.6%比 24.1%）。在校正协变量后，护士主导的项目的利用以及 MHI-5 和 KCCQ 评分的增加与 HF 再住院风险降低相关。
护士主导的项目对改善 CHF 患者的心理健康和生活质量有益，这可能有助于降低 HF 再住院率。
