農村部に住む心不全患者の自己ケアを改善するためのランダム化制御試験
Kathleen Dracup1, Debra K Moser2, Michele M Pelter2
1From the University of California San Francisco, School of Nursing, San Francisco (K.D., S.M.P., S.R.); University of Kentucky, College of Nursing, Lexington (D.K.M.); University of Nevada, Reno (M.M.P.); University of California, School of Medicine, Davis (T.S.N., J.S.); and National Heart, Lung and Blood Institute, Bethesda, MD (L.S.C.). kathy.dracup@nursing.ucsf.edu.
Circulation
|May 13, 2014
まとめ
農村部の心不全 (HF) 患者に関する研究では,看護師主導の教育プログラムが入院や心臓病による死亡を減少させなかったことが判明しました. しかし,LITEの介入は,通常のケアと比較して,心臓病による死亡率の有意な減少を示しました.
科学分野:
- 心臓病学 心臓病学
- 公衆衛生は公衆衛生である.
- 介護教育に関する教育
背景:
- 心不全 (HF) の農村人口は,心臓サービスへのアクセスを困難にしています.
- HF再入院と心臓死に対する教育介入の影響を評価するために,ランダム化された臨床試験が行われました.
研究 の 目的:
- 田舎の心不全患者に対する自己ケア教育介入の効果を評価する.
- 2つの介入の強度 (LITE vs. PLUS) が通常のケアに対して与える影響を比較する.
主な方法:
- 602人のHF患者は,コントロール,Fluid Watchers LITE,Fluid Watchers PLUSの3つのグループにランダムに分けられました.
- 介入には,対面教育とさまざまなレベルの看護師のフォローアップ電話が含まれていました.
- 主要複合エンドポイントは,HF再入院または2年間にわたる心疾患による死亡でした.
主要な成果:
- HF再入院または心疾患による死亡の複合的なアウトカムにおいて,3つのグループにおいて有意な差異は認められなかった (P=0.06).
- LITE群の患者は,対照群 (17.7%;P=0.003) と比較して,心疾患による死亡率 (7.5%) が著しく減少した.
- PLUSグループは,対照群と比較して,心臓死亡率の有意な違いを示さなかった.
結論:
- 面対面の教育介入は,心臓死またはHF入院の統合エンドポイントを有意に低下させなかった.
- PLUSグループにおける看護師との接触の頻度を増やすことは,LITEグループまたは通常のケアよりも良い結果をもたらさなかった.
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