Nurse-Led Multidisciplinary Heart Failure Group Clinic Appointments: Methods, Materials, and Outcomes Used in the Clinical Trial.
Nurse-Led Multidisciplinary Heart Failure Group Clinic Appointments: Methods, Materials, and Outcomes Used in the Clinical Trial.
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DOI：
10.1097/jcn.0000000000000255
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发表时间：
2015-07-01
期刊：
影响因子：
--
通讯作者：
Ellerbeck, Edward F
中科院分区：
文献类型：
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作者：
Smith, Carol E;Piamjariyakul, Ubolrat;Ellerbeck, Edward F
背景：心衰自我管理和护理小组临床试验评估多学科小组门诊预约对高危心衰（HF）患者自我护理技能和再住院的影响。目的：本文的目的是(1)通过小组诊所描述心力衰竭的关键自我管理和护理试验小组诊所互动学习策略，(2)描述小组诊所预约中使用的资源和材料，(3)提出支持这种以患者为中心的小组干预的结果。方法：该临床试验包括198例心衰患者（随机分配到组临床预约或标准治疗组）。数据收集自72个小组门诊就诊患者(1)小组门诊评估，(2)HF自我护理行为技能，(3)HF相关的气馁和生活质量评分，(4)HF相关的再住院，随访12个月。此外，小组临床预约的交付费用被制成表格。结果：总体而言，患者在管理HF评分方面的“有用性”评分为4.8分（满分5分）。统计模型显示，与对照组相比，干预组在12个月随访期间的再住院率（发生率比，0.67）降低33% （chi(2)1=3.9， P= 0.04）。实施5个小组预约的总费用为每位患者243.58美元。结论：干预与心衰自我护理知识和家庭护理行为技能的改善以及对心衰护理的管理有关。反过来，更好的自我保健与hf相关住院的减少有关。
BACKGROUND: The Self-management and Care of Heart Failure through Group Clinics Trial evaluated the effects of multidisciplinary group clinic appointments on self-care skills and rehospitalizations in high-risk heart failure (HF) patients.OBJECTIVE: The purpose of this article is to (1) describe key Self-management and Care of Heart Failure through Group Clinics Trial group clinic interactive learning strategies, (2) describe resources and materials used in the group clinic appointment, and (3) present results supporting this patient-centered group intervention.METHODS: This clinical trial included 198 HF patients (randomized to either group clinical appointments or to standard care). Data were collected from 72 group clinic appointments via patients' (1) group clinic session evaluations, (2) HF self-care behaviors skills, (3) HF-related discouragement and quality of life scores, and (4) HF-related reshopitalizations during the 12-month follow-up. Also, the costs of delivery of the group clinical appointments were tabulated.RESULTS: Overall, patients rated group appointments as 4.8 of 5 on the "helpfulness" in managing HF score. The statistical model showed a 33% decrease in the rate of rehospitalizations (incidence rate ratio, 0.67) associated with the intervention over the 12-month follow-up period when compared with control patients (chi(2)1=3.9, P=.04). The total cost for implementing 5 group appointments was $243.58 per patient.CONCLUSION: The intervention was associated with improvements in HF self-care knowledge and home care behavior skills and managing their for HF care. In turn, better self-care was associated with reductions in HF-related hospitalizations.