对于ESRD透析患者的短期预先护理计划干预 (VOICE) 的有效性:随机对照试验
Fang Xu1, Shuang Cheng1, Peng Shu1
1Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, People's Republic of China.
Patient preference and adherence
|December 29, 2025
概括
结构化的预先护理规划 (ACP) 干预改善了透析患者与末期病 (ESRD) 之间的参与和决策冲突. 这项研究突出了针对非洲,东南亚和东南亚地区的人口量身定制的非洲,东南亚和东南亚地区教育的潜力.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 抚慰性护理是一种缓解性护理.
- 医学伦理 医学伦理
背景情况:
- 预先护理计划 (ACP) 的随机对照试验 (RCT) 主要关注晚期癌症患者.
- 有限的证据表明,ACP干预措施对末期病患者 (ESRD) 的有效性.
研究的目的:
- 评估结构化的教育干预措施在加强ACP透析患者参与方面的有效性.
- 评估干预对决策冲突,对死亡的态度和ESRD患者生活质量的影响.
主要方法:
- VOICE研究是一项随机对照试验 (RCT),涉及102名透析患者.
- 干预组接受了针对ESRD患者量身定制的结构化ACP计划,而对照组接受了标准的护理.
- 主要结果是决策冲突 (决策冲突量表 - DCS);次要结果包括非洲和非洲的参与 (ACPES),对死亡的态度 (DAP-R) 和生活质量 (KDQOL-36TM).
主要成果:
- 干预小组在所有领域 (P < 0.05) 显示了ACP参与的显著改善.
- 观察到决策冲突的适度减少,特别是在与不确定性,知情决策和价值清晰度相关的DCS子表中.
- 干预组报告说,对死亡的恐惧减少,对死亡的接受程度更高,生活质量改善,特别是在病特定领域.
结论:
- 发言人ACP干预有效地改善了短期的ACP参与和透析患者的决策冲突.
- 建议进行进一步的多中心纵向研究,以评估这种干预措施的长期可持续性和成本效益.
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