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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.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
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[Clinical application of anticoagulation treatment with warfarin after prosthetic heart valve replacement: a single center-based survey].人工心脏瓣膜置换术后华法林抗凝治疗的临床应用：一项基于单中心的调查
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Evaluation of patients' knowledge on warfarin in outpatient pharmacy of a tertiary care cardiac center.在一家三级护理心脏中心的门诊药房对患者关于华法林的知识进行评估。
BMC Res Notes. 2015 Sep 10;8:429. doi: 10.1186/s13104-015-1416-1.
2
Knowledge, satisfaction, and concerns regarding warfarin therapy and their association with warfarin adherence and anticoagulation control.关于华法林治疗的知识、满意度及担忧，以及它们与华法林依从性和抗凝控制的关联。
Thromb Res. 2014 Apr;133(4):550-4. doi: 10.1016/j.thromres.2014.01.002. Epub 2014 Jan 7.
3
Antithrombotic therapies in patients with prosthetic heart valves: guidelines translated for the clinician.人工心脏瓣膜患者的抗血栓治疗：为临床医生翻译的指南。
J Thromb Thrombolysis. 2011 May;31(4):514-22. doi: 10.1007/s11239-011-0574-9.
4
Discharge teaching about warfarin: patient retention of knowledge.关于华法林的出院指导：患者知识留存情况
Home Healthc Nurse. 2010 Jun;28(6):366-74. doi: 10.1097/NHH.0b013e3181df5e87.
5
Treatment of prosthetic valve thrombosis: rationale for a prospective randomized clinical trial.人工瓣膜血栓形成的治疗：一项前瞻性随机临床试验的基本原理
J Heart Valve Dis. 2010 Mar;19(2):161-70.
6
Integrated Theory of Health Behavior Change: background and intervention development.健康行为改变综合理论：背景与干预措施发展
Clin Nurse Spec. 2009 May-Jun;23(3):161-70; quiz 171-2. doi: 10.1097/NUR.0b013e3181a42373.
7
Anticoagulation for mechanical heart valves: a role for patient based therapy.机械心脏瓣膜的抗凝治疗：基于患者的治疗方法的作用。
J Thromb Thrombolysis. 2008 Feb;25(1):18-25. doi: 10.1007/s11239-007-0105-x. Epub 2007 Dec 4.
8
Promoting behavior change: making healthy choices in wellness and healing choices in illness - use of self-determination theory in nursing practice.促进行为改变：在健康状态下做出健康选择，在患病时做出有助于康复的选择——自我决定理论在护理实践中的应用
Nurs Clin North Am. 2007 Jun;42(2):229-41, vi. doi: 10.1016/j.cnur.2007.02.003.
9
Comparison of outcomes among patients randomized to warfarin therapy according to anticoagulant control: results from SPORTIF III and V.根据抗凝控制情况对随机接受华法林治疗的患者的结局进行比较：SPORTIF III和V研究的结果。
Arch Intern Med. 2007 Feb 12;167(3):239-45. doi: 10.1001/archinte.167.3.239.
10
Factors influencing patient knowledge of warfarin therapy after mechanical heart valve replacement.机械心脏瓣膜置换术后影响患者对华法林治疗了解程度的因素。
J Cardiovasc Nurs. 2006 May-Jun;21(3):169-75; quiz 176-7. doi: 10.1097/00005082-200605000-00003.

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.

DOI:10.5090/kjtcs.20.106
PMID:33767008
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7946524/
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。