对阻断性睡眠呼吸暂停的护理协调和坚持促进的同行驱动干预:一个随机的,并行组临床试验
Sairam Parthasarathy1,2, Christopher Wendel1,2, Michael A Grandner1,3
1University of Arizona Health Sciences Center for Sleep, Circadian, and Neuroscience Research.
American journal of respiratory and critical care medicine
|October 23, 2024
概括
通过交互式语音响应 (IVR) 系统的同行支持显著改善了患者的满意度和对阻塞性睡眠呼吸暂停的持续正气道压力 (CPAP) 治疗的坚持. 这种方法提高了护理协调和患者的结果.
科学领域:
- 睡眠医学 睡眠医学
- 医疗保健服务研究 医疗服务研究
- 数字健康数字健康
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 很普遍,持续正气道压力 (CPAP) 治疗是常见的治疗方法.
- 对CPAP治疗的不良坚持是一个重大挑战,对患者的结果和经验产生负面影响.
- 患者满意度越来越被认为是医疗保健系统的关键质量指标.
研究的目的:
- 评估通过交互式语音响应 (IVR) 系统提供的同行驱动干预是否提高了患者的满意度.
- 与活跃对照组相比,评估基于IVR的同行支持对护理协调和CPAP遵守的影响.
主要方法:
- 一个为期6个月的随机,并行组,受控试验,涉及四个中心的263名患者.
- 参与者包括不使用CPAP的患者和接受过指导培训的CPAP患者.
- 干预组通过IVR系统获得同行支持;对照组获得标准护理.
主要成果:
- 干预组 (4.57 ± 0.71) 与对照组 (4.10 ± 1.13; P < 0.001) 相比,对睡眠特定服务的总体患者满意度显著更高.
- 与对照组相比,CPAP的坚持在干预组 (每晚4.5小时;每晚62.0%使用>4小时) 改善了 (每晚3.7小时;每晚51.4%使用>4小时;P=0.014和P=0.023).
- 干预组的慢性疾病护理患者评估 (P=0.009) 和客户对协调问卷的认知 (P=0.035) 评分有所改善.
结论:
- 使用IVR系统的同行驱动干预有效地提高了患者的满意度,CPAP的坚持和OSA管理中的护理协调.
- 这些发现表明,基于IVR的同行支持是改善OSA治疗结果的可行策略.
- 对同行支持服务的补偿政策可以促进这种干预措施的广泛实施.
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