Yuanyuan Li, Meng Liu, Yang Yang, Dongmei Zhu, Juan Ni, Chulin Chen
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引用次数: 0
Abstract
Background: Home enteral nutrition (HEN) is life-sustaining but poses long-term management challenges. One-time discharge education often fails to meet patients' evolving post-discharge needs. Video support offers a promising solution, yet its application in HEN rarely rests on a theoretical foundation to guide when and how support is delivered.
Methods: This prospective, two-arm randomized controlled trial randomly assigned 100 eligible patients in a 1:1 ratio to Timing It Right (TIR)-based staged video education (intervention) or video access at discharge (control). Outcomes (quality of life as the primary outcome; anxiety, depression, functional status, patient satisfaction, complications, readmissions as secondary outcomes) were assessed at baseline, 1 and 3 months. Data were analyzed with generalized estimating equations.
Results: The intervention group demonstrated significantly greater improvements in functional status (KPS) and reductions in anxiety (SAS) and depression (SDS) scores over time compared with the control group (all P ≤ 0.001), as well as an improvement in patient satisfaction (PSQ-18, P < 0.05). No significant differences were found in quality of life (NutriQoL), readmission rates, or complication incidence. Video engagement data indicated high interest in self-management and complication content.
Conclusion: A TIR-based staged video intervention is feasible and effective for improving key patient-centered outcomes in HEN. Tailored information at critical post-discharge timepoints addresses evolving needs. Future research should include multicenter trials with longer follow-up and integrate multidimensional support to enhance quality of life.
背景:家庭肠内营养(HEN)是维持生命,但存在长期管理挑战。一次性的出院教育往往不能满足患者不断变化的出院后需求。视频支持提供了一个很有前途的解决方案,但它在HEN中的应用很少依赖于理论基础来指导何时以及如何提供支持。方法:这项前瞻性、双组随机对照试验将100名符合条件的患者按1:1的比例随机分配到基于Timing It Right (TIR)的分阶段视频教育(干预)或出院时视频访问(对照组)。结果(生活质量作为主要结果,焦虑、抑郁、功能状态、患者满意度、并发症、再入院作为次要结果)在基线、1个月和3个月进行评估。用广义估计方程对数据进行分析。结果:与对照组相比,干预组在功能状态(KPS)、焦虑(SAS)和抑郁(SDS)评分方面的改善明显更大(P均≤0.001),患者满意度(PSQ-18, P)也有显著改善。结论:基于tir的分阶段视频干预对于改善HEN的关键患者中心结局是可行和有效的。在关键的出院后时间点提供量身定制的信息,以满足不断变化的需求。未来的研究应包括多中心试验,随访时间更长,并整合多维支持,以提高生活质量。
期刊介绍:
NCP is a peer-reviewed, interdisciplinary publication that publishes articles about the scientific basis and clinical application of nutrition and nutrition support. NCP contains comprehensive reviews, clinical research, case observations, and other types of papers written by experts in the field of nutrition and health care practitioners involved in the delivery of specialized nutrition support. This journal is a member of the Committee on Publication Ethics (COPE).