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护士主导的过渡期护理方案对中国冠心病患者再入院率、实施促进健康行为自我效能、功能状态和生活质量的影响:一项随机对照试验。

Effects of a nurse-led transitional care programme on readmission, self-efficacy to implement health-promoting behaviours, functional status and life quality among Chinese patients with coronary artery disease: A randomised controlled trial.

机构信息

College of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan, Hebei, China.

Department of Oncological Surgery, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China.

出版信息

J Clin Nurs. 2018 Mar;27(5-6):969-979. doi: 10.1111/jocn.14064. Epub 2018 Jan 8.

Abstract

AIMS AND OBJECTIVES

To examine the effectiveness of a nurse-led transitional care programme on readmission, self-efficacy to implement health-promoting behaviours, functional status and life quality among Chinese patients with coronary artery disease.

BACKGROUND

Coronary artery disease is a major cause of mortality in China. Transitional care could help to ensure improved patient outcomes. Nevertheless, our knowledge of how to perform transitional care for patients with coronary artery disease is insufficient in mainland China.

DESIGN

Randomised controlled trial.

METHODS

The nurse-led transitional care intervention in the experimental group adopted the Omaha system and Pender's health-promoting model as its frameworks. The control group received a comparable length routine care and follow-up contacts. Evaluations were conducted at baseline before discharge and after 7 months after discharge using hospital readmission rate, self-rated abilities for health practices scale and Seattle Angina Questionnaire for functional status and life quality. Data were collected between March 2014-October 2014.

RESULTS

Compared with the control group, participants in the experimental group showed greater self-efficacy to implement health-promoting behaviours, more angina stability, less angina frequency, more satisfaction with treatment and better quality of life. The difference in readmission rate and physical limitations was not significant between the two groups.

CONCLUSION

This study provides evidence for the effectiveness of a nurse-led transitional care programme in improving the ability to implement health-promoting behaviours, the functional status and life quality among Chinese patients with coronary artery disease.

RELEVANCE TO CLINICAL PRACTICE

The nurse-led transitional care programme is helpful for coronary artery disease patients to promote their effective transfer from hospital to community and provide an evidence for nursing managers to train their nurses for transitional care knowledge and skills.

摘要

目的

探讨护士主导的过渡期护理方案对中国冠心病患者再入院率、实施促进健康行为的自我效能、功能状态和生活质量的影响。

背景

冠心病是中国主要的死亡原因。过渡期护理可以帮助改善患者的结局。然而,我们对于如何为冠心病患者提供过渡期护理的了解在中国内地还不够充分。

设计

随机对照试验。

方法

实验组的护士主导的过渡期护理干预采用奥马哈系统和彭德健康促进模式作为框架。对照组接受了类似长度的常规护理和随访。在出院前和出院后 7 个月分别使用住院再入院率、自我评估健康实践能力量表和西雅图心绞痛问卷评估功能状态和生活质量进行评估。数据收集于 2014 年 3 月至 10 月。

结果

与对照组相比,实验组的参与者在实施促进健康行为的自我效能、心绞痛稳定性、心绞痛发作频率、治疗满意度和生活质量方面均有显著提高。两组在再入院率和身体限制方面的差异无统计学意义。

结论

本研究为护士主导的过渡期护理方案在提高中国冠心病患者实施促进健康行为的能力、功能状态和生活质量方面的有效性提供了证据。

临床意义

护士主导的过渡期护理方案有助于冠心病患者从医院向社区的有效转移,并为护理管理人员培训护士过渡期护理知识和技能提供了依据。

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