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垂体瘤患者术后的以人为本的支持。

Person-centered support for patients with a pituitary tumor following surgery.

作者信息

Jakobsson Sofie, Ragnarsson Oskar, Hallén Tobias, Krabbe David, Olofsson Ann-Charlotte, Olsson Daniel S, Trimpou Penelope, Skoglund Thomas, Johannsson Gudmundur

出版信息

Endocr Connect. 2025 Jan 28;14(3). doi: 10.1530/EC-24-0686. Print 2025 Mar 1.

Abstract

OBJECTIVES

To evaluate whether a person-centered care practice following surgery for pituitary tumors increased psychological well-being. Secondary aims were to study whether person-centered care would lead to better health status, less fatigue and better self-efficacy.

DESIGN AND METHODS

This study is a prospective, single-center study using a quasi-experimental design to evaluate the effect of a 12-month person-centered practice by means of a name-given nurse care manager, an interdisciplinary team and peer support against usual care. All patients (≥18 years) with a benign pituitary tumor and planned for endoscopic transsphenoidal surgery were consecutively invited to participate. Psychological well-being, self-reported health, fatigue and self-efficacy were assessed before surgery, at discharge and 3-6 and 12 months after surgery.

RESULTS

In total, 86 patients in the intervention group and 68 patients in the control group were included. Psychological well-being improved 12 months following surgery in both groups to comparable levels. The intervention group had a greater improvement in anxiety compared to the control group (P = 0.02). No differences were seen between groups in self-reported health status, fatigue or self-efficacy. Patients in the intervention group with other types of pituitary tumors than non-functioning pituitary adenomas showed a greater improvement in psychological well-being than in the control group.

CONCLUSION

Our intervention did not result in major advantages in terms of health or psychological well-being. The study does, however, suggest that the intervention may reduce anxiety 12 months after surgery and that certain subgroups of patients may benefit more from a structured person-centered practice following pituitary surgery.

摘要

目的

评估垂体瘤手术后以患者为中心的护理实践是否能提高心理健康水平。次要目的是研究以患者为中心的护理是否会带来更好的健康状况、更少的疲劳感和更强的自我效能感。

设计与方法

本研究是一项前瞻性单中心研究,采用准实验设计,通过指定的护士护理经理、跨学科团队和同伴支持,评估为期12个月的以患者为中心的实践相对于常规护理的效果。连续邀请所有计划接受内镜经蝶窦手术的良性垂体瘤患者(≥18岁)参与。在手术前、出院时以及术后3至6个月和12个月评估心理健康、自我报告的健康状况、疲劳感和自我效能感。

结果

干预组共纳入86例患者,对照组共纳入68例患者。两组患者术后12个月时心理健康水平均有所改善,且达到了可比水平。与对照组相比,干预组的焦虑改善情况更明显(P = 0.02)。两组在自我报告的健康状况、疲劳感或自我效能感方面未发现差异。与无功能性垂体腺瘤以外的其他类型垂体瘤患者相比,干预组患者的心理健康改善情况比对照组更明显。

结论

我们的干预措施在健康或心理健康方面并未带来显著优势。然而,该研究表明,干预措施可能会在术后12个月减轻焦虑,并且某些亚组患者可能会从垂体瘤手术后结构化的以患者为中心的实践中获益更多。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfd/11799750/7ba3fea897ed/EC-24-0686fig1.jpg

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