心衰患者姑息治疗教育模块的影响和可持续性。

Shelley L Thompson, Allison Lindgren, Jaime McDermott, Stephanie G Barnes, Carolina D Tennyson, Bradi Granger
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引用次数: 0

摘要

背景:大约670万美国成年人患有心力衰竭(HF)。目前的治疗方法主要是防止病情恶化和控制症状,因为无法治愈。多项研究表明,在心衰患者中采用姑息治疗(PC)可以改善症状和生活质量。心力衰竭指南建议将PC纳入治疗,但转诊往往被推迟。先前的一个试点项目表明,当对心衰患者进行有针对性的教育时,PC的参与增加了。目的:对心衰患者进行PC教育,探讨对PC就诊、再入院、死亡率、重症监护病房(ICU)转院的影响,并评价干预的可持续性。方法:在某学术医院诊断为心衰的患者(n = 124)被要求观看PC上的教育模块。完成模块的患者分为干预组(n = 39)。拒绝接受治疗的患者被置于常规护理组(n = 38)。我们比较了参与者和那些减少的患者的PC咨询次数、再入院次数、死亡率和转到ICU的次数。结果与以前的试点项目进行了比较。结果:干预组(IG) 11例患者要求PC会诊,常规护理组(UCG) 1例(P = 0.006)。两组患者再入院率、死亡率或ICU转院率均无统计学差异。结论:这个可持续的项目再次证明了PC教育提高了PC的利用率,但在统计上对死亡率、再入院率或转移到更高水平的护理没有影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact and Sustainability of a Palliative Care Education Module in Patients With Heart Failure.

Background: Approximately 6.7 million American adults are living with heart failure (HF). Current therapies are geared toward preventing progression and managing symptoms, as there is no cure. Multiple studies have shown the benefit of including palliative care (PC) in patients with HF to improve symptoms and quality of life. Heart failure guidelines recommend the inclusion of PC in therapy, but referrals are often delayed. A previous pilot project demonstrated increased involvement of PC when targeted education was given to patients with HF.

Objective: Educate patients with HF on PC and examine the impact on PC consults, readmission, mortality, intensive care unit (ICU) transfers and evaluate sustainability of the intervention.

Methods: Patients (n = 124) admitted to an academic hospital with a diagnosis of HF were asked to view an educational module on PC. Patients who completed the module were placed in the intervention group (n = 39). Patients who declined were placed in the usual care group (n = 38). The number of PC consults, re-admissions, mortality, and transfers to the ICU were compared among participants and those who declined. Results were compared to previous pilot project.

Results: Eleven patients in the intervention group (IG) requested a PC consult vs one in the usual care group (UCG) (P = .006). There was no statistically significant difference in readmissions, mortality, or ICU transfers between groups.

Conclusions: This sustainable project again demonstrated education on PC increases utilization of PC but does not statistically impact mortality, re-admissions, or transfers to higher levels of care.

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