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希腊的一项慢性阻塞性肺疾病自我管理干预措施,旨在改善初级保健中的患者报告结局。

A Chronic Obstructive Pulmonary Disease Self-Management Intervention for Improving Patient-Reported Outcomes in Primary Care in Greece.

机构信息

Department of Social Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece.

Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece.

出版信息

Medicina (Kaunas). 2024 Feb 23;60(3):377. doi: 10.3390/medicina60030377.

Abstract

: Self-management programs are essential for increasing COPD patient participation and autonomy in making appropriate decisions about their chronic condition. The present study aimed to assess the impact of COPD self-management interventions on quality of life, functional status, patient education, depression, and anxiety in primary care. : We conducted a randomized controlled trial recruiting patients with COPD (GOLD A and B) from four primary care centers in Crete, Greece, with one intervention group ( = 40) receiving self-management educational support and one control group ( = 80) receiving usual care. To measure quality of life, functional status, patient education, depression, and anxiety, we used patient-reported outcome measures (PROMs) at baseline and 6 months post-intervention, including the Short-Form Health survey (SF-12), Clinical COPD Questionnaire (CCQ), mMRC, Beck Anxiety Inventory (BAI), Beck Depression Inventory, Health Education Impact Questionnaire (HeiQ), and Health Literacy Questionnaire (HLQ). : At the end of the 6-month intervention, most PROMs improved significantly in the intervention group ( < 0.05) but did not show significant changes in the control group. The greatest improvements at follow-up compared to baseline measurements were observed for dyspnea (mMRC-38.6%), anxiety (BAI-35%), depression (BDI-20.2%), COPD health status (CCQ-34.1%), and the actively managing my health subscale of HLQ (23.5%). : Our results suggest that a self-management intervention could be an effective strategy for improving PROMs in primary care. Although more research is needed to identify the long-term effects of such interventional programs, policymakers could implement similar programs to improve the overall health of these patients.

摘要

自我管理计划对于增加 COPD 患者参与度和自主决策能力至关重要,有助于他们更好地管理自身的慢性疾病。本研究旨在评估 COPD 自我管理干预对初级保健中患者生活质量、功能状态、患者教育、抑郁和焦虑的影响。

我们开展了一项随机对照试验,在希腊克里特岛的四个初级保健中心招募了 COPD(GOLD A 和 B)患者,其中干预组(n=40)接受自我管理教育支持,对照组(n=80)接受常规护理。我们在基线和干预后 6 个月使用患者报告的结局测量指标(PROMs)评估生活质量、功能状态、患者教育、抑郁和焦虑,包括简明健康调查量表(SF-12)、临床 COPD 问卷(CCQ)、mMRC 量表、贝克焦虑量表(BAI)、贝克抑郁量表、健康教育培训影响问卷(HeiQ)和健康素养问卷(HLQ)。

在 6 个月的干预结束时,干预组的大多数 PROMs 显著改善(<0.05),而对照组则没有显著变化。与基线测量相比,随访时观察到的最大改善是呼吸困难(mMRC-38.6%)、焦虑(BAI-35%)、抑郁(BDI-20.2%)、COPD 健康状况(CCQ-34.1%)和积极管理健康子量表的 HLQ(23.5%)。

我们的研究结果表明,自我管理干预可能是改善初级保健中 PROMs 的有效策略。尽管需要进一步研究来确定此类干预计划的长期效果,但政策制定者可以实施类似的计划,以改善这些患者的整体健康状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91f6/10972103/e285685088f8/medicina-60-00377-g001.jpg

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