Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization - A randomized trial
Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization - A randomized trial
复制标题
DOI：
10.1097/00005650-199901000-00003
复制
发表时间：
1999-01-01
期刊：
影响因子：
3
通讯作者：
Holman, HR
中科院分区：
文献类型：
--
作者：
Lorig, KR;Sobel, DS;Holman, HR
目标。这项研究评估了慢性病自我管理计划的有效性(健康行为、健康状况和卫生服务利用的变化)，该计划设计用于不同类型的慢性病患者组。方法：这项研究是一项为期6个月的社区随机对照试验，比较了治疗对象和等待名单控制对象。参与者是952名年龄在40岁或以上的患者，他们被医生证实患有心脏病、肺部疾病、中风或关节炎。结果：与对照组相比，治疗组在6个月后在每周锻炼分钟数、认知症状管理频率、与医生沟通、自我报告健康状况、健康困扰、疲劳、残疾和社交/角色活动限制方面表现出改善。他们的住院次数和住院天数也较少。在疼痛/身体不适、呼吸急促或心理健康方面没有发现差异。结论：专门为满足不同慢性病患者群体的需求而设计的干预措施，在改善健康行为和健康状况方面是可行的，而且在改善健康行为和健康状况方面比常规护理更有益。它还导致住院人数和住院天数减少。
OBJECTIVES. This study evaluated the effectiveness (changes in health behaviors, health status, and health service utilization) of a self-management program for chronic disease designed for use with a heterogeneous group of chronic disease patients. It also explored the differential effectiveness of the intervention for subjects with specific diseases and comorbidities.METHODS. The study was a six-month randomized, controlled trial at community-based sites comparing treatment subjects with wait-list control subjects. Participants were 952 patients 40 years of age or older with a physician-confirmed diagnosis of heart disease, lung disease, stroke, or arthritis. Health behaviors, health status, and health service utilization, as determined by mailed, self-administered questionnaires, were measured.RESULTS. Treatment subjects, when compared with control subjects, demonstrated improvements at 6 months in weekly minutes of exercise, frequency of cognitive symptom management, communication with physicians, self-reported health, health distress, fatigue, disability, and social/role activities limitations. They also had fewer hospitalizations and days in the hospital. No differences were found in pain/physical discomfort, shortness of breath, or psychological well-being.CONCLUSIONS. An intervention designed specifically to meet the needs of a heterogeneous group of chronic disease patients, including those with comorbid conditions, was feasible and beneficial beyond usual care in terms of improved health behaviors and health status. It also resulted in fewer hospitalizations and days of hospitalization.