UiT, The Arctic University of Norway, Tromsø, Norway.
University Hospital of North Norway, UNN Harstad, Tromsø, Norway.
BMC Health Serv Res. 2022 Dec 31;22(1):1602. doi: 10.1186/s12913-022-08985-1.
Inflammatory bowel disease (IBD), consisting of Crohn's disease (CD) and ulcerative colitis (UC), is a chronic disorder with a considerable negative impact on health-related quality of life (HRQoL). During the past decade, IBD nurse specialists have been increasingly involved in follow-up care of IBD outpatients, in a consultative and coordinating role, closely cooperating with gastroenterologists. Whether patients' HRQoL differs between nurses' follow-up care (NF) and conventional follow-up care (CF) has not been widely researched and the aim of this study was to compare two different follow-up regimes with respect to patients' HRQoL.
This cross-sectional, multicenter study involved seven centers; five organized as CF, two as NF.
A total of 304 patients aged 18-80 years, 174 females and 130 males, were included, of whom 140 received care under the NF model and 164 under the CF model. Participants in the NF group had a statistically significant higher median total score on the Inflammatory Bowel Disease Questionnaire (IBDQ) (p-value < .001). This pattern could also be seen in the sub-scores of the different IBDQ domains. Despite a trend of higher IBDQ score in all domains in the NF model, the overall result in our study did not reach the limit of 16 points, defined as clinically significant. A higher proportion of NF patients had IBDQ scores defined as remission, as well as a statistically significant higher frequency of outpatient check-ups during a two-year follow-up period.
Nurse-led models are not inferior to conventional models with regards to patient reported HRQoL except in the social domain where the model showed to be clinically significant better. Further studies are needed to advance efforts to implement these models and increase access to IBD care.
炎症性肠病（IBD）包括克罗恩病（CD）和溃疡性结肠炎（UC），是一种慢性疾病，对健康相关生活质量（HRQoL）有相当大的负面影响。在过去的十年中，IBD 护士专家越来越多地参与 IBD 门诊患者的随访护理，以咨询和协调的角色，与胃肠病学家密切合作。患者的 HRQoL 是否在护士随访护理（NF）和常规随访护理（CF）之间存在差异尚未得到广泛研究，本研究的目的是比较两种不同的随访方案对患者 HRQoL 的影响。
这是一项横断面、多中心研究，涉及七个中心；五个组织为 CF，两个为 NF。
共纳入 304 名年龄在 18-80 岁之间的患者，其中 174 名为女性，130 名为男性，其中 140 名患者接受 NF 模式护理，164 名患者接受 CF 模式护理。NF 组患者的炎症性肠病问卷（IBDQ）总分中位数具有统计学显著更高（p 值<.001）。这种模式也可以在不同 IBDQ 域的子分数中看到。尽管 NF 模型中所有域的 IBDQ 评分均呈上升趋势，但本研究的总体结果并未达到 16 分的临床显著水平。NF 组患者中有更高比例的 IBDQ 评分定义为缓解，并且在两年的随访期间，门诊检查的频率也具有统计学显著更高。
在患者报告的 HRQoL 方面，护士主导的模式并不逊于常规模式，除了在社会领域，该模式显示出临床显著的优势。需要进一步的研究来推进实施这些模式并增加 IBD 护理的可及性。
