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失代偿期乙型肝炎肝硬化患者参与式医疗指导方案的构建与应用

Construction and Application of Patient-Participated Health Care Guidance Plan for Patients with Decompensated Hepatitis B Cirrhosis.

作者信息

Su Dan, Zeng Xiange, Tang Yinliang, Wang Wenjing

机构信息

Department of Gastroenterology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan Province, 421001, People's Republic of China.

出版信息

Hepat Med. 2024 Jun 4;16:45-54. doi: 10.2147/HMER.S455557. eCollection 2024.

Abstract

OBJECTIVE

The goal of this study was to develop and assess the effectiveness of a patient-engaged healthcare guidance plan for individuals with decompensated hepatitis B cirrhosis.

METHODS

This study employed literature review, situational analysis, and expert consultations to create a healthcare guidance plan that includes patient participation for those suffering from decompensated hepatitis B cirrhosis. Between January 2022 and January 2023, 86 patients with this condition admitted to our hospital were selected through convenience sampling and randomly assigned into two groups using a random number table. The control group (n=43) received standard care, while the intervention group (n=43) received the novel patient-engaged healthcare guidance in addition to standard care. We compared both groups in terms of anxiety and depression levels, self-care capability, uncertainty about their illness, and overall quality of life.

RESULTS

Upon discharge, scores for the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Mishel's Uncertainty in Illness Scale (MUIS) decreased in both groups compared to their scores at admission (P<0.05), with the intervention group showing more significant improvements than the control group (P<0.05). Additionally, scores for the Self-Care Ability Scale (ESCA) and the component threshold scores of the Health Survey Short Form (SF-36) increased for both groups from admission to discharge (P<0.05), with the intervention group showing greater improvements than the control group (P<0.05).

CONCLUSION

The patient-engaged healthcare guidance plan developed for individuals with decompensated hepatitis B cirrhosis proved to be highly effective. It significantly reduced patient anxiety and depression, enhanced self-care capabilities, diminished illness uncertainty, and improved overall quality of life.

摘要

目的

本研究的目的是为失代偿期乙型肝炎肝硬化患者制定并评估一项患者参与的医疗指导计划的有效性。

方法

本研究采用文献综述、情境分析和专家咨询来创建一项医疗指导计划,该计划包括让失代偿期乙型肝炎肝硬化患者参与其中。2022年1月至2023年1月期间,通过便利抽样选取了我院收治的86例该疾病患者,并使用随机数字表将其随机分为两组。对照组(n = 43)接受标准护理,而干预组(n = 43)除标准护理外还接受新的患者参与的医疗指导。我们比较了两组患者的焦虑和抑郁水平、自我护理能力、对疾病的不确定性以及总体生活质量。

结果

出院时,两组患者的自评焦虑量表(SAS)、自评抑郁量表(SDS)和米舍尔疾病不确定感量表(MUIS)得分均较入院时下降(P < 0.05),且干预组的改善程度比对照组更显著(P < 0.05)。此外,两组患者的自我护理能力量表(ESCA)得分和健康调查简表(SF - 36)的分量表阈值得分从入院到出院均有所增加(P < 0.05),干预组的改善程度比对照组更大(P < 0.05)。

结论

为失代偿期乙型肝炎肝硬化患者制定的患者参与的医疗指导计划被证明是非常有效的。它显著降低了患者的焦虑和抑郁,增强了自我护理能力,减少了疾病不确定性,并改善了总体生活质量。

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