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个性化护士主导教育项目对机械心脏瓣膜置换术后接受口服抗凝治疗的新患者治疗依从性的影响

Effects of a Personalized Nurse-Led Educational Program for New Patients Receiving Oral Anticoagulant Therapy after Mechanical Heart Valve Prosthesis Implantation on Adherence to Treatment.

作者信息

Eltheni Rokeia, Schizas Nikolaos, Michopanou Nektaria, Fildissis Georgios

机构信息

Cardiac Surgery Intensive Care Unit, "Evangelismos" General Hospital of Athens, Greece.

Faculy of Nursing, School of Healthcare Sciences, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

J Chest Surg. 2021 Feb 5;54(1):25-30. doi: 10.5090/kjtcs.20.106.

Abstract

BACKGROUND

Life-long anticoagulant therapy is mandatory for patients who undergo heart valve replacement with implantation of a mechanical prosthesis. The aim of this study was to investigate the effects of a nurse-led patient educational program concerning oral anticoagulant therapy intake after heart valve replacement surgery on patients' knowledge of important parameters of anticoagulant administration.

METHODS

In this single-center study, 200 patients who underwent surgical implantation of a mechanical prosthesis were divided into 2 groups. The control group received the basic education concerning oral anticoagulants, while the intervention group received a personalized educational program.

RESULTS

Personalized education was correlated with a better regulation of therapeutic international normalized ratio (INR) levels and adequate knowledge among patients. Therapeutic levels of INR were achieved in 45% of the patients during the first month, 71% in the third month, and 89% in the sixth month after discharge in the intervention group, compared to 25%, 47%, and 76% in the control group, respectively. Patients' satisfaction with the information was higher in the intervention group than in the control group. The percentage of satisfaction reached 80% for the intervention group versus 37% for the patients of the control group.

CONCLUSION

The implementation of the nurse-led educational programs was associated with improved clinical results and increased adherence to oral anticoagulant treatment.

摘要

背景

对于接受心脏瓣膜置换并植入机械假体的患者,终身抗凝治疗是必需的。本研究的目的是调查由护士主导的关于心脏瓣膜置换术后口服抗凝治疗的患者教育项目对患者抗凝管理重要参数知识的影响。

方法

在这项单中心研究中,200例接受机械假体手术植入的患者被分为两组。对照组接受关于口服抗凝剂的基础教育,而干预组接受个性化教育项目。

结果

个性化教育与更好地调节治疗性国际标准化比值(INR)水平以及患者的充分知识相关。干预组出院后第一个月、第三个月和第六个月达到治疗性INR水平的患者分别为45%、71%和89%,而对照组分别为25%、47%和76%。干预组患者对信息的满意度高于对照组。干预组的满意度达到80%,而对照组患者为37%。

结论

由护士主导的教育项目的实施与改善临床结果和增加口服抗凝治疗的依从性相关。

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