国家卫生服务内的高级临床实践人员领导的息护理心力衰竭模型:对患者体验,医疗保健成本和生命终结结果的前性研究
Stephanie Kirkland1, Patrick Tran2,1, Fazidatul Aziz1
1University Hospitals Coventry & Warwickshire, Clifford Bridge Road, CV2 2DX, UK.
European journal of cardiovascular nursing
|March 3, 2026
概括
由高级从业者领导的新的息性心力衰竭 (HF) 模型改善了患者满意度和节省成本,但生活质量 (QoL) 却下降了. 提前息治疗 (PC) 转诊建议在晚期HF患者.
科学领域:
- 心脏病学 心脏病学
- 抚慰性护理是一种缓解性护理.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 尽管有证据表明有好处,但心力衰竭 (HF) 中的息治疗 (PC) 整合在英国是有限的.
- 晚期HF患者面临着生活质量低下 (QoL),经常住院和分散的护理.
研究的目的:
- 评估基于指导方针的,由心力衰竭高级临床从业者 (HFACP) 领导的缓解性心力衰竭模型.
- 评估对生活质量,医疗保健利用率,成本和生命终结结果的影响.
主要方法:
- 在6个月内对100名晚期HF患者进行前性混合方法队列研究.
- 干预措施包括基于家庭的PC和远程医疗,通过QoL分数 (KCCQ-23,EQ-5D-5L) 来衡量结果,节省成本,以及提前护理计划 (ACP) 的采用.
- 还评估了患者的满意度和首选死亡地点.
主要成果:
- 患者满意度高 (93%) 和加大了非洲和非洲国家的参与度 (81%完成了讨论).
- 由于避免住院,大约节省了672,743.50英的成本.
- 观察到QOL得分下降 (EQ-5D-5L和KCCQ-23);低KCCQ得分与死亡率增加和医疗保健使用相关.
- 42.3%的死亡发生在家中,符合人们的偏好.
结论:
- 由HFACP主导的模型在患者满意度,ACP参与度和成本降低方面取得了成功.
- 随着QOL的下降和远程医疗的低采用率,表明需要更早的PC转诊和有针对性的战略.
- 低KCCQ分数可以识别需要及时缓解干预的高风险患者.
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