University of São Paulo, Ribeirão Preto, Brazil.
Department of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, WA, USA.
J Clin Nurs. 2021 Oct;30(19-20):3011-3022. doi: 10.1111/jocn.15811. Epub 2021 Apr 23.
To evaluate the effect of reinforcing an educational programme through telephone follow-up on health-related quality of life and anxiety and depression symptoms in individuals starting warfarin therapy.
Educational interventions have improved quality of life in individuals using warfarin. Few studies have examined the addition of telephone follow-up to enhance educational interventions.
Randomised controlled trial in outpatient setting.
Hospitalised adults starting warfarin therapy who agreed to participate received an educational programme about the warfarin treatment. At discharge, they were randomised to receive either five telephone follow-up calls (intervention) or no telephone calls (controls). Both groups were evaluated for health-related quality of life (using Duke Anticoagulation Satisfaction Scale) and symptoms of anxiety and depression (using Hospital Anxiety and Depression Scale) at three and six months post-discharge. Groups were compared at each time by independent-samples t test, and over time by repeated-measures analysis of variance, with time (three and six months), groups (intervention and control) and an interaction between time and group as factors. Level of significance was set at 0.05. The Consolidated Standards of Reporting Trials was used for reporting.
Fifty-two individuals (26 per group) completed the study. There were no statistical differences between groups in health-related quality of life, anxiety and depression symptoms, at both times post-discharge. Participants who received follow-up telephone calls reported better positive psychological impact (a subscale of quality of life) than controls.
Reinforcing an educational programme with telephone follow-ups did not have an overall effect on health-related quality of life of individuals using warfarin but promoted positive psychological impact.
The low cost of reinforcing educational programmes with telephone calls and the improvement in positive psychological aspects indicate that this type of intervention is still a promising intervention that could be further investigated and improved.
评估通过电话随访强化教育计划对开始华法林治疗的个体健康相关生活质量和焦虑抑郁症状的影响。
教育干预可改善使用华法林的个体的生活质量。很少有研究研究过增加电话随访以增强教育干预的效果。
门诊环境下的随机对照试验。
接受华法林治疗的住院成年人同意参与后，接受有关华法林治疗的教育计划。出院时，他们被随机分配接受五次电话随访（干预组）或不接受电话随访（对照组）。两组均在出院后三个月和六个月时评估健康相关生活质量（使用杜克抗凝满意度量表）和焦虑抑郁症状（使用医院焦虑抑郁量表）。通过独立样本 t 检验在每个时间点比较两组，并通过重复测量方差分析随时间进行比较，时间（三个月和六个月）、组（干预和对照）以及时间和组之间的相互作用作为因素。显著性水平设为 0.05。采用 CONSORT 报告标准进行报告。
52 名个体（每组 26 名）完成了研究。出院后两个时间点，两组在健康相关生活质量、焦虑和抑郁症状方面均无统计学差异。接受随访电话的参与者报告的积极心理影响（生活质量的一个亚量表）优于对照组。
强化教育计划辅以电话随访并没有对华法林使用者的健康相关生活质量产生总体影响，但促进了积极的心理影响。
强化教育计划的电话随访成本低，且可改善积极的心理方面，这表明这种干预措施仍具有很大的潜力，可以进一步研究和改进。
