由执业护士或医生治疗的患者的初级保健结果:一项随机试验
M O Mundinger1, R L Kane, E R Lenz
1School of Nursing, Columbia University, New York, NY 10032, USA. mm44@columbia.edu
JAMA
|January 13, 2000
概括
执业护士和医生提供可比的初级保健结果. 这项随机试验发现类似的健康状况和服务利用率,在护士执业患者中略有更好的透气血压控制.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 主要护理是指初级护理.
- 护理实践 护理实践
背景情况:
- 之前的研究表明,初级保健护士 (NP) 和医生之间的质量可比.
- 在将NP实践与同等独立性和直接患者结果数据进行比较方面存在差距.
- 缺乏直接比较从NP获得初级保健的患者与医生的结局.
研究的目的:
- 为了比较患者在随机分配到执业护士或初级保健医生后的结果.
- 评估后续和持续的护理后急诊室或紧急护理访问.
主要方法:
- 一个随机试验,从1995年8月到1997年10月进行.
- 1316名没有定期护理的成年人被随机分配到NP (n=806) 或医生 (n=510) 的初级护理.
- 评估结果包括患者满意度,健康状况 (SF-36),生理测量和6个月和1年的服务利用率.
主要成果:
- 6个月后健康状况没有显著差异 (P=.92) 或糖尿病 (P=.77) 或喘 (P=.82) 的生理测试结果.
- 患有高血压的执业护士患者显示出统计学上显著的更低的透静血压 (82比85毫米升;P=.04).
- 在医疗服务利用方面没有显著差异;整体满意度相似,尽管医生在6个月后在提供者属性上被评为略高 (P=.05).
结论:
- 在具有同等NP和医生权力和责任的门诊护理环境中,患者的结果是可比的.
- 这项研究支持在初级保健中使用护士执业人员,其角色和责任与医生相似.
- 研究结果表明,执业护士可以有效地管理初级保健后续和持续护理.
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