AF-EduCare和AF-EduApp方法提高房颤患者房颤知识及危险因素认知的有效性：一项随机对照试验

Effectiveness of the AF-EduCare and AF-EduApp approach to improve atrial fibrillation knowledge and risk factor awareness in patients with atrial fibrillation: a randomized controlled trial.

作者信息

Knaepen Lieselotte, Desteghe Lien, Delesie Michiel, Önder Rana, Vijgen Johan, Dendale Paul, Ector Joris, Heidbuchel Hein

机构信息

Antwerp University Hospital, Cardiology Center, Drie Eikenstraat 655, Edegem 2650, Belgium.

Research Group Cardiovascular Diseases, University of Antwerp, Prinsstraat 13, Antwerp 2000, Belgium.

出版信息

Eur J Cardiovasc Nurs. 2025 Mar 3;24(2):266-276. doi: 10.1093/eurjcn/zvae164.

DOI:10.1093/eurjcn/zvae164

PMID:39780354

Abstract

AIMS

Developing an integrated care pathway for atrial fibrillation (AF) patients is of pivotal importance, given the different treatment strategies. Moreover, knowledge about the condition is an important factor in engaging patients in their care. Patient education formed the core of the integrated AF-EduCare/AF-EduApp approach. The main aim of this manuscript is to report the impact of this approach on AF and risk factor (RF)-related knowledge and self-care awareness.

METHODS AND RESULTS

Atrial fibrillation patients (n = 1232) were randomized to standard care (SC) or three educational interventions: in-person, online, or app-based education. Patients in the intervention groups received targeted education based on their responses to the Jessa Atrial fibrillation Knowledge Questionnaire (JAKQ) and a Self-Care Questionnaire (SCQ) presented at different time points. Patients who received educational follow-up reached a significantly higher knowledge score (in-person: 86.5 ± 13.2%; online: 82.5 ± 19.3%; app: 80.1 ± 15.0%) than the SC group (65.3 ± 16.6%) after 12/18 months (P < 0.001). The knowledge rapidly improved with the first sessions (i.e. 3 months) and remained sustained in all education groups. Patients with RF at baseline showed a slight but significant increase in awareness about their RF through education [e.g. no knowledge of last measured systolic blood pressure compared between education vs. SC: odds ratio of 0.45 (P = 0.012)], a change that was not seen in SC patients. Nevertheless, patients keep under-estimating the presence of their own RFs compared with objective documentation in their medical record (e.g. hypertension).

CONCLUSION

The JAKQ and SCQ are good instruments to provide targeted education to AF patients in daily clinical care. Knowledge level increases clinically significantly, but the impact on awareness about personal risk factors remains unsatisfactory.

REGISTRATION

ClinicalTrials/gov: NCT03707873NCT03788044.

摘要

目的

鉴于房颤（AF）患者存在不同的治疗策略，制定综合护理路径至关重要。此外，对病情的了解是促使患者参与自身护理的重要因素。患者教育是AF-EduCare/AF-EduApp综合方法的核心。本手稿的主要目的是报告该方法对房颤及危险因素（RF）相关知识和自我护理意识的影响。

方法与结果

房颤患者（n = 1232）被随机分为标准护理组（SC）或三种教育干预组：面对面教育、在线教育或基于应用程序的教育。干预组患者根据其在不同时间点对耶萨房颤知识问卷（JAKQ）和自我护理问卷（SCQ）的回答接受针对性教育。接受教育随访的患者在12/18个月后，其知识得分（面对面教育：86.5±13.2%；在线教育：82.5±19.3%；应用程序教育：80.1±15.0%）显著高于SC组（65.3±16.6%）（P < 0.001）。知识在最初几次课程（即3个月）时迅速提高，并在所有教育组中持续保持。基线时存在RF的患者通过教育对其RF的认识有轻微但显著的提高[例如，教育组与SC组相比，对上次测量的收缩压一无所知：优势比为0.45（P = 0.012）]，而SC组患者未出现这种变化。然而，与病历中的客观记录（如高血压）相比，患者仍低估自身RF的存在。