以护士为主导的同伴支持干预对中风幸存者心理社会结果的影响：随机对照试验

IF 7.5 1区医学 Q1 NURSING

International Journal of Nursing Studies Pub Date : 2024-09-04 DOI:10.1016/j.ijnurstu.2024.104892

Xiaojuan Wan , Dorothy Ngo Sheung Chan , Janita Pak Chun Chau , Yu Zhang , Yuexia Liao , Pinting Zhu , Kai Chow Choi

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引用次数: 0

摘要

背景：中风患者的生活面临许多社会心理挑战。目前还缺乏改善中风幸存者社会心理结果的干预措施。同伴支持干预可能有助于中风后的康复。然而，目前还没有足够的证据表明同伴支持干预可用于提高中风幸存者的社会心理健康水平：本研究旨在评估由护士主导的同伴支持干预对改善中风幸存者心理社会效果的有效性：设计：评估者盲法双臂随机对照试验，注意对照组：环境：中国扬州的一家社区卫生中心和一家康复中心：首次或复发缺血性或出血性脑卒中幸存者：方法：招募了 120 名中风幸存者，将其中 60 人随机分配到干预组和对照组。干预组参与者接受以护士为主导的同伴支持干预。对照组参与者则接受关注护理。主要结果是社会参与和参与自我效能。次要结果是心理困扰、感知到的社会支持、对疾病的耻辱感和生活质量。数据收集时间为基线（T0）、干预后不久（T1）和干预后三个月（T2）。采用广义估计方程模型来确定干预对结果的影响：结果：干预明显改善了社会参与（T1：调整后的平均差 = -18.45，95 % CI：-22.89 至 -14.01，P 结论：结果为干预的有效性提供了实证支持：结果：干预明显改善了卒中幸存者的社会参与（T1：调整后的平均差=-18.45，95 % CI：-22.89 到-14.01，p）。结果为护士主导的同伴支持干预在改善卒中幸存者心理社会结局方面的有效性提供了经验支持，并为将同伴支持纳入卒中康复提供了更多证据：注册：ChiCTR.org.cn（ChiCTR2100050853），招募开始：招募开始时间：2021年10月。

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Effects of a nurse-led peer support intervention on psychosocial outcomes of stroke survivors: A randomised controlled trial

Background

Living with stroke poses many psychosocial challenges. Interventions for improving stroke survivors' psychosocial outcomes are lacking. Peer support interventions may contribute to recovery after stroke. However, current evidence is insufficient to suggest their application in enhancing stroke survivors' psychosocial well-being.

Objective

This study aimed to evaluate the effectiveness of a nurse-led peer support intervention for improving the psychosocial outcomes of stroke survivors.

Design

An assessor-blinded two-arm randomised controlled trial with an attention control group.

Settings

A community health centre and a rehabilitation unit in Yangzhou, China.

Participants

First-ever or recurrent ischaemic or haemorrhagic stroke survivors.

Methods

A convenience sample of 120 stroke survivors was recruited with 60 participants randomly assigned to each of the intervention and control groups. Intervention group participants received the nurse-led peer support intervention. Control group participants received attention care. The primary outcomes were social participation and participation self-efficacy. The secondary outcomes were psychological distress, perceived social support, stigma towards diseases, and quality of life. Data were collected at baseline (T0), immediately post-intervention (T1) and three months post-intervention (T2). Generalised estimating equations models were used to determine the effects of the intervention on the outcomes.

Results

The intervention significantly improved social participation (T1: adjusted mean difference = − 18.45, 95 % CI: − 22.89 to − 14.01, p < 0.001; T2: adjusted mean difference = − 14.71, 95 % CI: − 22.36 to − 7.05, p < 0.001), participation self-efficacy (T1: adjusted mean difference = 47.92, 95 % CI: 37.56 to 58.27, p < 0.001; T2: adjusted mean difference = 39.58, 95 % CI: 17.88 to 61.28, p < 0.001) and perceived social support (T1: adjusted mean difference = 7.56, 95 % CI: 4.93 to 10.19, p < 0.001; T2: adjusted mean difference = 7.41, 95 % CI: 4.01 to 10.80, p < 0.001), and reduced psychological distress (T1: adjusted mean difference = − 4.97, 95 % CI: − 6.25 to − 3.69, p < 0.001; T2: adjusted mean difference = − 4.67, 95 % CI: − 6.24 to − 3.11, p < 0.001) and stigma towards diseases (T1: adjusted mean difference = − 3.83, 95 % CI: − 5.14 to − 2.51, p < 0.001; T2: adjusted mean difference = − 3.19, 95 % CI: − 5.20 to − 1.19, p < 0.001) at both T1 and T2. The intervention significantly improved quality of life at T1 only (adjusted mean difference = 0.12, 95 % CI: 0.06 to 0.19, p = 0.02).

Conclusions

The results provide empirical support for the effectiveness of the nurse-led peer support intervention in improving the psychosocial outcomes of stroke survivors and provide additional evidence to support their inclusion in stroke rehabilitation.

Registration

ChiCTR.org.cn (ChiCTR2100050853), Start of recruitment: October 2021.

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来源期刊

International Journal of Nursing Studies 医学-护理

CiteScore

15.00

自引率

2.50%

发文量

181

审稿时长

21 days

期刊介绍： The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).