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在昌迪加尔城郊社区由护士主导的非传染性疾病诊所中,通过任务分担管理常见非传染性疾病

Task Sharing for Managing Common Noncommunicable Disease in a Nurse Led Noncommunicable Diseases Clinic in Peri-Urban Community of Chandigarh.

作者信息

Kashyap Neha, Kavita Kavita, Saini Sushma Kumari, Singh Amarjeet

机构信息

National Institute of Nursing Education, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Indian J Community Med. 2022 Oct-Dec;47(4):596-599. doi: 10.4103/ijcm.ijcm_1048_21. Epub 2022 Dec 14.

Abstract

BACKGROUND

Nurse led noncommunicable diseases (NCD) clinic may address the significant shortage of human resource for health for managing common NCDs. The objective of this study is to assess the feasibility and effectiveness of nurse-led NCD clinic for identification, prevention, and management of common NCDs.

MATERIALS AND METHODS

A quasi experimental study was conducted at a Public Health Dispensary in periurban community of Northern India. Situational analysis and stakeholders' interview were done based on which the clinic was setup and run over a period of 2 months by registered nurses and nursing students to offer screening, health education and appropriate referral. The primary outcome of study was proportion of population screened, prevalence of common NCDs, risk factors modification, medication adherence, and patient satisfaction.

RESULTS

It was feasible to run a nurse led clinic in terms of availability of space, equipment to run the clinic and human resource. A total of 455 individuals aged ≥30 years were enrolled using the total enumeration sampling technique. There was a significant increase in screening rates from 0.29% to 3.7% in nurse-led NCD clinic. There was significant mean change in systolic blood pressure (18.75 ± 6.92 mm Hg), diastolic blood pressure (4.4 ± 3.71 mm Hg), random blood sugar (33.36 ± 38.49 mg/dl) Body Mass Index, and waist circumference ( < 0.01) among the population screened. Medication adherence significantly increased from 7.8% to 76.4% ( < 0.01) after 2 months of nurse-led NCD clinic.

CONCLUSION

Task sharing for managing common NCDs in nurse-led NCD clinic was feasible and effective in increasing screening rates, medication adherence, and risk factors modification among studied population.

摘要

背景

由护士主导的非传染性疾病(NCD)诊所可能有助于解决管理常见非传染性疾病的卫生人力资源严重短缺问题。本研究的目的是评估由护士主导的非传染性疾病诊所对常见非传染性疾病的识别、预防和管理的可行性和有效性。

材料与方法

在印度北部城郊社区的一家公共卫生诊疗所进行了一项准实验研究。进行了情境分析和利益相关者访谈,在此基础上,由注册护士和护理专业学生设立并运营该诊所两个月,以提供筛查、健康教育和适当转诊。研究的主要结果是筛查人群的比例、常见非传染性疾病的患病率、危险因素的改善、药物依从性和患者满意度。

结果

从诊所空间、运营设备和人力资源方面来看,由护士主导的诊所是可行的。采用整群抽样技术共纳入了455名年龄≥30岁的个体。在由护士主导的非传染性疾病诊所中,筛查率从0.29%显著提高到了3.7%。在接受筛查的人群中,收缩压(18.75±6.92毫米汞柱)、舒张压(4.4±3.71毫米汞柱)、随机血糖(33.36±38.49毫克/分升)、体重指数和腰围均有显著的平均变化(P<0.01)。在由护士主导的非传染性疾病诊所运营2个月后,药物依从性从7.8%显著提高到了76.4%(P<0.01)。

结论

在由护士主导的非传染性疾病诊所中,分担管理常见非传染性疾病的任务对于提高研究人群的筛查率、药物依从性和危险因素改善是可行且有效的。

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