Nursing interventions for patients with chronic conditions
Nursing interventions for patients with chronic conditions
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DOI：
10.1046/j.1365-2648.2003.02779.x
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发表时间：
2003-10-01
影响因子：
3.8
通讯作者：
Frich, LMH
中科院分区：
文献类型：
--
作者：
Frich, LMH
背景。保持老年人的独立性或恢复和鼓励慢性病患者的自我管理，是提高与健康有关的生活质量的方法，同时可以节省费用。护士经常在后续家访中进行这些类型的干预。描述在家访期间的护理干预措施及其对患有一系列慢性疾病的人的影响。使用Medline、Embase、PsycINFO、CINAHL和Cochrane数据库，使用术语慢性或糖尿病或关节炎*或疼痛、随机*和[（护士*和护理）或（护士*和干预）]进行结构化描述性综述。在老年人中，如果目标人群是“较年轻的老年人”，或者如果干预措施是针对声称有健康问题的老年人，则可达到最佳效果。效果取决于随访期的持续时间、随访次数和护士的个性。糖尿病患者的后续护理干预可以改善心理社会和健康结果。对卫生保健提供者的教育和与患者相处的时间似乎对积极的结果很重要。风湿病专科护士似乎可以提供与风湿病专家同样好的临床结果，并产生更好的患者相关结果。与在日间护理或住院治疗患者的多学科团队相比，风湿病专科护士提供的患者满意度较低，但同样良好的临床结果。慢性病患者往往受益于护士的随访。访问应该是多次的，长期的，干预应该是个体化的。结果可以描述为患者满意度，良好的临床结果和成本节约。未来的随机对照试验应描述护士的干预措施和教育背景，以便进行复制。使用卫生技术评估方法的随机对照试验将允许在研究之间进行比较，并为今后的决策奠定良好的基础。
Background. Maintaining independence in older people or restoring and encouraging self-management in those with chronic conditions are ways of increasing health-related quality of life and at the same time may achieve cost savings. Nurses often carry out these types of interventions in follow-up home visits.Aims. To describe nursing interventions during home visits and their effects on people suffering from a range of chronic conditions.Method. A structured descriptive review was carried out using the Medline, Embase, PsycINFO, CINAHL and Cochrane databases and the terms chronic or diabetic or arthrit* or pain and randomi* and [(nurs* and care) or ( nurs* and interventions)].Findings. In older people the best outcomes are reached if the target population is 'the younger-old', or if intervention is tailored to elders who have stated health problems. The effect depends on the duration of the follow-up period, number of follow-up visits and personality of the nurse. Follow-up nursing interventions for patients with diabetes can improve psychosocial and health outcomes.Education of health providers and amount of time spent with patients seem to be important for positive outcome. A rheumatology nurse specialist seems to provide equally good clinical results as a rheumatologist and produces better patient-related outcomes. Compared with a multidisciplinary team treating patients in day care or inpatient settings, a rheumatology nurse specialist provides less patient satisfaction, but equally good clinical outcomes.Conclusions. Patients with chronic conditions often benefited from follow-up visits by nurses. Visits should be multiple, extended over a long-term, and interventions should be individualized. The outcomes may be described as patient satisfaction, good clinical outcomes and cost savings. Future randomized controlled trials should describe nurses' interventions and educational background to enable replication. Randomized controlled trials using the Health Technology Assessment method would permit comparison between studies and be a good foundation for future decision-making.