反导法对心衰患者知识、表现、再入院及生活质量的影响。

IF 1.8 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiology Research and Practice Pub Date : 2020-11-23 eCollection Date: 2020-01-01 DOI:10.1155/2020/8897881
Ali Rahmani, Amir Vahedian-Azimi, Masoud Sirati-Nir, Reza Norouzadeh, Hamid Rozdar, Amirhossein Sahebkar
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引用次数: 18

摘要

背景:在慢性疾病中,心力衰竭一直是一个严重的挑战,给卫生系统和社会带来高昂的成本。因此,护士应采取新的教育策略,提高自我护理行为,减少心力衰竭患者的再入院率。本研究旨在确定反导法对这些患者的知识、表现、再入院和生活质量的影响。方法:本临床试验以2019年在德黑兰Baqiyatallah al-Azam医疗中心住院的心力衰竭患者(n = 70)为研究对象。对照组患者接受常规出院教育。采用反教的方法对干预组进行自我保健主题教学。采用心脏自我保健问卷,评估患者在干预后立即和出院后3个月的知识和实践情况。同时,给每位患者注射SF-36。出院后3个月通过电话随访患者的再入院情况和生活质量。在反教前、反教后立即和反教后3个月对组内比较进行重复测量、方差分析和相关事后检验。采用Wilks’lambda多元检验同时比较干预组和对照组的生活质量量表。此外,在控制基线测量和混杂因素后进行了逻辑回归。结果:反教教育后,患者的知识和表现均有显著改善,但在出院后的长期效果较慢。此外,通过反导教育,患者的再入院频率降低,生活质量(身体功能除外)提高。通过控制前测效应,干预组和对照组患者的生活质量相关成分的后测得分均有改善。通过使用二元逻辑回归分析控制基线测量,证实了生活质量的改善。结论:反教教育提高了患者的知识和表现,减少了再入院次数,提高了患者的生活质量。
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The Effect of the Teach-Back Method on Knowledge, Performance, Readmission, and Quality of Life in Heart Failure Patients.

Background: Among chronic diseases, heart failure has always been a serious challenge imposing high costs on health systems and societies. Therefore, nurses should adopt new educational strategies to improve self-care behaviors and reduce the readmissions in heart failure patients. This study aimed to determine the effect of the teach-back method on knowledge, performance, readmission, and quality of life in these patients.

Methods: This clinical trial was conducted in patients with heart failure (n = 70) hospitalized in the internal wards of the Baqiyatallah al-Azam Medical Center in Tehran (2019). Routine discharge educations were provided in control patients. Self-care topics were taught to the intervention groups by the teach-back method. A cardiac self-care questionnaire was used to assess the knowledge and practice of patients immediately after intervention and three months after patient discharge. Also, SF-36 was presented to each patient. Readmission(s) and quality of life were followed up by telephone interviews three months after patient discharge. Repeated measures analysis of variance and related post-hoc tests were performed for within-group comparisons before, immediately after, and 3 months after teach-back education. Wilks' lambda multivariate tests were conducted for simultaneous comparison of quality of life subscales between intervention and control groups. Also, logistic regressions were after controlling for baseline measures and confounders.

Results: Findings showed significant improvement in the patients' knowledge and performance immediately after teach-back education, though this effect was slow in the long term after discharge. Also, the frequency of readmissions decreased and the quality of life (except physical function) increased in the patients through teach-back education. By controlling for the pretest effect, the posttest scores for the relevant components of the quality of life suggested improvement in both intervention and control patients. This improvement in the quality of life was confirmed by controlling for baseline measurements using binary logistic regression analysis.

Conclusion: Teach-back education improved patients' knowledge and performance, readmission frequency, and quality of life.

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来源期刊
Cardiology Research and Practice
Cardiology Research and Practice Medicine-Cardiology and Cardiovascular Medicine
CiteScore
4.40
自引率
0.00%
发文量
64
审稿时长
13 weeks
期刊介绍: Cardiology Research and Practice is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies that focus on the diagnosis and treatment of cardiovascular disease. The journal welcomes submissions related to systemic hypertension, arrhythmia, congestive heart failure, valvular heart disease, vascular disease, congenital heart disease, and cardiomyopathy.
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