护士主导的自我护理指导对全喉切除老年患者的干预效果：一项随机对照试验
Effectiveness of a nurse-led coaching in self-care intervention for elderly undergoing total laryngectomy: a randomised controlled trial.
作者信息
Zheng Liyuan, Chen Jian, Wang Huifen, Peng Danxia, Lu Yuchen, Liu Shu'e, Liu Yan, Li Xue, Ye Sanxia, Mei Zhidan, Wei Lai, Xu Chun
机构信息
Department of Head and Neck Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Nursing, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
BMJ Open. 2024 Dec 20;14(12):e078948. doi: 10.1136/bmjopen-2023-078948.
OBJECTIVES
To evaluate the effectiveness of nurse-led coaching in self-care (SC) interventions for elderly patients undergoing total laryngectomy (TL) using multidimensional parameters.
DESIGN
This was a double-arm randomised, single-centre trial that met the requirements of the CONSORT statement.
SETTING
Head and neck department in a tertiary A-level hospital.
INTERVENTION
Elderly patients scheduled for TL were randomly allocated to either the control group (n=24) or the intervention group (n=23). Patients in the control group received routine nursing care during hospitalisation and, subsequently, at home after discharge, received conventional family care without the regular supervision of nurses. Patients in the intervention group received a series of SC interventions led by nurses during hospitalisation and discharge and implemented SC practice using the home SC manual (SC knowledge and SC diary), nurses regularly supervised and evaluated the SC effect. The primary outcome was the SC ability. Secondary outcomes were self- efficacy, quality of life (QoL) and nutritional status.
RESULTS
The SC intervention improved the SC ability, self-efficacy, QoL and nutritional status scores of patients in the intervention group compared with that of patients in the control group (p<0.01). The outcomes showed that the intervention had a significant effect on SC ability, self-efficacy and QoL scores, with both the main effects of time and intervention, as well as their interaction being significant (p<0.05). Nutritional status, as assessed using the PG-SGA, was better in the intervention group than in the control group (p<0.001). No adverse events (AEs) were observed in either group.
CONCLUSION
Nurse-led SC intervention for elderly patients with TL is an effective strategy that can bring multidimensional benefits, including higher self-efficacy, stronger SC ability to actively solve health problems, better QoL and nutritional status, as well as shorter hospital stays.
TRIAL REGISTRATION NUMBER
ChiCTR2100043731.
目的
采用多维参数评估护士主导的自我护理（SC）干预措施对接受全喉切除术（TL）的老年患者的有效性。
设计
这是一项双臂随机单中心试验，符合CONSORT声明的要求。
地点
一所三级甲等医院的头颈科。
干预措施
计划接受TL的老年患者被随机分为对照组（n = 24）或干预组（n = 23）。对照组患者在住院期间接受常规护理，出院后在家中接受传统家庭护理，无护士定期监督。干预组患者在住院和出院期间接受护士主导的一系列SC干预措施，并使用家庭SC手册（SC知识和SC日记）进行SC实践，护士定期监督和评估SC效果。主要结局是SC能力。次要结局是自我效能感、生活质量（QoL）和营养状况。
结果
与对照组患者相比，SC干预提高了干预组患者的SC能力、自我效能感、QoL和营养状况评分（p<0.01）。结果表明，干预对SC能力、自我效能感和QoL评分有显著影响，时间和干预的主效应及其交互作用均显著（p<0.05）。使用PG-SGA评估的营养状况，干预组优于对照组（p<0.001）。两组均未观察到不良事件（AE）。
结论
护士主导的针对TL老年患者的SC干预是一种有效的策略，可带来多方面益处,包括更高的自我效能感、更强的主动解决健康问题的SC能力、更好的QoL和营养状况，以及缩短住院时间。
试验注册号
ChiCTR2100043731。
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