Comparison of a one-time educational intervention to a teach-to-goal educational intervention for self-management of heart failure: design of a randomized controlled trial.
Comparison of a one-time educational intervention to a teach-to-goal educational intervention for self-management of heart failure: design of a randomized controlled trial.
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DOI：
10.1186/1472-6963-9-99
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发表时间：
2009-06-11
影响因子：
2.8
通讯作者：
Pignone M
中科院分区：
文献类型：
--
作者：
DeWalt DA;Broucksou KA;Hawk V;Baker DW;Schillinger D;Ruo B;Bibbins-Domingo K;Holmes M;Weinberger M;Macabasco-O'Connell A;Pignone M
心力衰竭(HF)是一种常见的、昂贵的疾病，并与显著的发病率和较低的生活质量有关，特别是对于社会经济地位较低的患者。自我管理培训已被证明可以降低心力衰竭相关的发病率和住院率，但对于如何最好地提供这种培训以及哪些患者受益还不确定。这项研究比较了单节自我管理HF训练计划和多节训练干预，并检查了它们的效果是否因识字水平而不同。在这项随机对照的多点试验中，英语和西班牙语患者从美国4个地点的大学附属普通内科和心脏病诊所招募而来。符合条件的患者有心力衰竭，并有纽约心脏协会II-IV级症状，并被开出环状利尿剂的处方。基线数据，包括识字水平，在登记时收集，并在登记后1、6和12个月进行跟踪调查，对照组和干预组都接受相同的40分钟、识字敏感的面对面HF教育课程，涵盖每日自我评估的4个关键自我管理部分，并制定计划、避免食盐、锻炼和服药坚持。所有参与者还会收到一本对识字敏感的练习册和一个数字卫生间秤。基线教育完成后，患者被随机分配到常规护理或接受持续的教育和培训。干预组接受额外的20分钟关于体重和基于症状的利尿剂自我调节的教育，以及在一年的过程中来自教育者的定期随访电话。这些电话旨在加强教育，评估参与者对教育的了解，并解决成功的障碍。主要结果是所有原因、住院和死亡的综合发生率。次要结果包括心力衰竭相关的生活质量、心力衰竭相关的住院治疗、关于心力衰竭的知识、自我护理行为和自我效能。每种干预措施的效果将根据患者的文化程度进行分层，以确定任何不同的效果。拟议的660门科目的招生工作将持续到2009年底。预计成果评估将于2011年初完成。ClinicalTrials.gov NCT00378950
Heart failure (HF) is common, costly and associated with significant morbidity and poor quality of life, particularly for patients with low socioeconomic status. Self-management training has been shown to reduce HF related morbidity and hospitalization rates, but there is uncertainty about how best to deliver such training and what patients benefit. This study compares a single session self-management HF training program against a multiple session training intervention and examines whether their effects differ by literacy level. In this randomized controlled multi-site trial, English and Spanish-speaking patients are recruited from university-affiliated General Internal Medicine and Cardiology clinics at 4 sites across the United States. Eligible patients have HF with New York Heart Association class II-IV symptoms and are prescribed a loop diuretic. Baseline data, including literacy level, are collected at enrollment and follow-up surveys are conducted at 1, 6 and 12 months Upon enrollment, both the control and intervention groups receive the same 40 minute, literacy-sensitive, in-person, HF education session covering the 4 key self-management components of daily self assessment and having a plan, salt avoidance, exercise, and medication adherence. All participants also receive a literacy-sensitive workbook and a digital bathroom scale. After the baseline education was completed, patients are randomly allocated to return to usual care or to receive ongoing education and training. The intervention group receives an additional 20 minutes of education on weight and symptom-based diuretic self-adjustment, as well as periodic follow-up phone calls from the educator over the course of 1 year. These phone calls are designed to reinforce the education, assess participant knowledge of the education and address barriers to success. The primary outcome is the combined incidence of all cause hospitalization and death. Secondary outcomes include HF-related quality of life, HF-related hospitalizations, knowledge regarding HF, self-care behavior, and self-efficacy. The effects of each intervention will be stratified by patient literacy, in order to identify any differential effects. Enrollment of the proposed 660 subjects will continue through the end of 2009. Outcome assessments are projected to be completed by early 2011. ClinicalTrials.gov NCT00378950
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影响因子：
5.7
作者：
Sudore, Rebecca L.;Yaffe, Kristine;Schillinger, Dean
通讯作者：
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影响因子：
5.9
作者：
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影响因子：
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作者：
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作者：
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通讯作者：
Huang, Jenny
DOI：
10.1164/rccm.200409-1291oc
发表时间：
2005-10-15
影响因子：
24.7
作者：
Paasche-Orlow, MK;Riekert, KA;Krishnan, JA
通讯作者：
Krishnan, JA