Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Department of Surgery, Södersjukhuset, Stockholm, Sweden.
Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Sophiahemmet University, Department of Health Promoting Science, Stockholm, Sweden.
Eur J Vasc Endovasc Surg. 2023 Sep;66(3):371-379. doi: 10.1016/j.ejvs.2023.06.030. Epub 2023 Jun 29.
The aim was to evaluate the effect of a person centred nurse led follow up programme on health related quality of life (HRQoL), health literacy, and general self efficacy compared with standard care for patients undergoing revascularisation for intermittent claudication (IC), and to describe factors associated with HRQoL one year after revascularisation.
This was a secondary analysis of a randomised controlled trial. Patients with IC scheduled for revascularisation at two vascular surgery centres in Sweden between 2016 and 2018 were randomised to intervention or control. During the first year after surgery, the intervention group received a person centred follow up programme with three visits and two telephone calls with a vascular nurse, while the control group received standard follow up with two visits to a vascular surgeon or vascular nurse. Outcomes were HRQoL measured by VascuQol-6, health literacy, and general self efficacy measured by validated questionnaires.
Overall, 214 patients were included in the trial; this secondary analysis comprised 183 patients who completed the questionnaires. One year after revascularisation, HRQoL had improved with a mean increase in VascuQol-6 of 7.0 scale steps (95% CI 5.9 - 8.0) for the intervention and 6.0 scale steps (95% CI 4.9 - 7.0) for the control group; the difference between the groups was not significant (p = .18). In an adjusted regression analysis, the intervention was associated with higher VascuQoL-6 (2.0 scale steps, 95% CI 0.08 - 3.93). There was no significant difference between the groups regarding health literacy or general self efficacy. The prevalence of insufficient health literacy among all participants was 38.7% (46/119) at baseline and 43.2% (51/118) at one year.
In this study, a person centred, nurse led follow up programme had no significant impact on HRQoL, health literacy, or general self efficacy among patients undergoing revascularisation for IC. The prevalence of insufficient health literacy was high and should be addressed by healthcare givers and researchers.
评估以人为中心的护士主导的随访方案对间歇性跛行（IC）患者血管重建术后健康相关生活质量（HRQoL）、健康素养和一般自我效能的影响，并描述与血管重建术后 1 年 HRQoL 相关的因素。
这是一项随机对照试验的二次分析。2016 年至 2018 年期间，瑞典两家血管外科中心计划进行血管重建术的 IC 患者被随机分为干预组或对照组。术后第一年，干预组接受以人为中心的随访方案，包括三次血管护士访视和两次电话随访，而对照组接受标准随访，包括两次血管外科医生或血管护士访视。采用 VascuQol-6 量表评估 HRQoL，采用经过验证的问卷评估健康素养和一般自我效能。
共有 214 名患者参加了试验，本二次分析纳入了 183 名完成问卷的患者。血管重建术后 1 年，干预组 HRQoL 改善，VascuQol-6 评分平均增加 7.0 个量表步（95%CI 5.9-8.0），对照组增加 6.0 个量表步（95%CI 4.9-7.0）；两组间差异无统计学意义（p=0.18）。在调整后的回归分析中，干预与 VascuQol-6 评分较高相关（2.0 个量表步，95%CI 0.08-3.93）。两组间健康素养或一般自我效能无显著差异。所有参与者在基线时的健康素养不足发生率为 38.7%（46/119），1 年后为 43.2%（51/118）。
在这项研究中，以人为中心、护士主导的随访方案对 IC 患者血管重建术后的 HRQoL、健康素养或一般自我效能无显著影响。健康素养不足的发生率较高，应引起医疗保健提供者和研究人员的重视。
