Kaltenbrunner Monica, Flink Maria, Brandberg Carina, Hellström Amanda, Ekstedt Mirjam
Linnaeus University Faculty of Health and Life Sciences, Kalmar, Sweden.
University of Gävle Faculty of Health and Occupational Studies, Gavle, Sweden.
BMJ Open. 2025 Apr 14;15(4):e081931. doi: 10.1136/bmjopen-2023-081931.
The aim is to evaluate the effects of a motivational interviewing-based intervention, Supporting Patient Activation in Transition to Home, on rehospitalisation and patient activation among patients with heart failure or chronic obstructive pulmonary disease.
A randomised, controlled, analysis-blinded trial was conducted.
Participants were recruited from two hospitals in mid-Sweden and the intervention and interviews were conducted post-discharge.
207 participants with heart failure or chronic obstructive pulmonary disease were recruited. Participants were randomised to receive five motivational interviewing sessions post-discharge (n=103) or a control group (n=104).
Rehospitalisation within 180 days post-discharge was retrieved, and patient activation was assessed using the Patient Activation Measure at baseline, 30, 90 and 180 days post-discharge. We used a generalised estimating equation to assess the difference in the secondary outcome, patient activation, between the intervention group and the control group during the 180-day follow-up.
No statistically significant differences between the groups were found for rehospitalisation (p=0.33 to 0.41) or patient activation over time (B=-1.67, -0.71 and -0.83 (95% CI -5.45 to 2.10, -4.06 to 2.64 and -4.28 to 2.62), respectively).
Post-discharge motivational interviewing to decrease rehospitalisation or support patient activation does not seem beneficial for patients with heart failure or chronic obstructive pulmonary disease. The high disease burden may have limited patient participation in the intervention.
NCT02823795.
旨在评估一种基于动机性访谈的干预措施“支持患者过渡到家庭中的自我管理”对心力衰竭或慢性阻塞性肺疾病患者再入院率和患者自我管理能力的影响。
进行了一项随机对照、分析设盲试验。
参与者从瑞典中部的两家医院招募,干预措施和访谈在出院后进行。
招募了207名心力衰竭或慢性阻塞性肺疾病患者。参与者被随机分为出院后接受五次动机性访谈(n = 103)或对照组(n = 104)。
获取出院后180天内的再入院情况,并在基线、出院后30天、90天和180天使用患者自我管理能力量表评估患者自我管理能力。我们使用广义估计方程评估干预组和对照组在180天随访期间次要结局指标患者自我管理能力的差异。
两组在再入院率(p = 0.33至0.41)或随时间推移的患者自我管理能力方面均未发现统计学上的显著差异(B分别为-1.67、-0.71和-0.83(95%CI -5.45至2.10、-4.06至2.64和-4.28至2.62))。
出院后进行动机性访谈以降低再入院率或支持患者自我管理能力,对心力衰竭或慢性阻塞性肺疾病患者似乎并无益处。高疾病负担可能限制了患者对干预措施的参与。
NCT02823795。