一项平行分组随机试验，研究由护士联络员提供阴道镜检查结果对患者报告结果和依从性的影响。

IF 2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada Pub Date : 2024-09-26 DOI:10.1016/j.jogc.2024.102668

Sarah J. Mah MD, MSc , Lori A. Brotto PhD, R Psych , Maggie Bryce MSc , Susan Keast CHRL , Arianne Albert PhD , Marette Lee MD, MPH

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引用次数: 0

摘要

目的：宫颈癌在加拿大呈上升趋势。解决患者的焦虑并提高患者对阴道镜检查和结果的理解，可以提高患者的依从性。这项随机对照试验研究了由护士联络员提供阴道镜检查结果与转诊初级保健提供者（PCP）提供阴道镜检查结果对患者焦虑的影响，以及患者满意度、诊断知识和 9 个月坚持随访等次要结果。在收到阴道镜检查结果后，参与者在线填写焦虑量表（STAI）、医疗保健满意度量表（PSQ-18、HAI、VSQ-9）、自我报告的阴道镜诊断和人口统计学资料。9 个月后的病历审查评估了对建议的阴道镜检查随访的坚持情况。结果：干预组的状态焦虑明显降低，STAI-状态平均分为 37.3，而对照组为 40.7（P = 0.03）。干预组参与者更有可能正确报告诊断结果（84% 对 66.3%，P = 0.003）。问卷回答者更有可能属于干预组，其 CIN2+ 病变的比例也更高。结论：由训练有素的护士联络员直接提供阴道镜检查结果可降低患者对阴道镜检查结果的焦虑，增加患者对诊断的了解。目标：宫颈癌在加拿大呈上升趋势。通过消除患者的焦虑并解释阴道镜检查及其结果，可以提高患者的依从性。这项随机临床试验研究了由联络护士或提出请求的初级保健医生（PCP）传达阴道镜检查结果对患者焦虑的影响。次要结果指标包括患者满意度、诊断知识和 9 个月随访的依从性。方法：首次到阴道镜检查诊所就诊的 18 岁及以上患者按 1:1 的比例随机分配到干预组（联络护士）或对照组（MPL）。在收到阴道镜检查结果后，参与者填写在线焦虑量表（STAI）和医疗满意度量表（PSQ-18、HAI、VSQ-9），并提供自我报告的阴道镜诊断结果和人口统计学特征。通过 9 个月的病历审查评估了患者对阴道镜检查后建议随访的依从性。根据连续变量和分类变量对两组进行比较，同时考虑到诊断的严重程度和焦虑特质。结果：干预组的焦虑状态明显降低，STAI 平均分为 37.3 分，对照组为 40.7 分（P = 0.03）。干预组的参与者更有可能正确报告自己的诊断（84% p/r 66.3%; P = 0.003）。干预组的受访者更有可能患有 CIN2+ 疾病，且比例更高。结论：由受过培训的联络护士直接告知阴道镜检查结果可减少患者对检查结果的焦虑，并增加患者对诊断的了解。这种模式可用于改善以患者为中心的护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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A Parallel-Group, Randomized Trial Examining Impact of Colposcopy Results Delivery by a Nurse Liaison on Patient-Reported Outcomes and Adherence

Objectives

Cervical cancer is on the rise in Canada. Addressing patient anxiety and improving patient understanding of colposcopy and results may improve adherence. This randomized controlled trial examined the impact of colposcopy results delivery by a Nurse Liaison versus the referring primary care provider (PCP) on patient anxiety, and secondary outcomes including patient satisfaction, knowledge of diagnosis, and 9-month adherence to follow-up.

Methods

Patients ≥18 years old presenting for initial appointment at the study colposcopy clinic were randomized 1:1 to an intervention group (Nurse Liaison) versus a control group (PCP). After receiving colposcopy results, participants completed online measures of anxiety (State-Trait Anxiety Inventory), health care satisfaction scales (Patient Satisfaction Questionnaire-18, Health Anxiety Inventory, Visit-Specific Satisfaction Questionnaire-9), self-reported colposcopy diagnosis, and demographics. Chart review at 9 months assessed adherence to recommended colposcopy follow-up. Groups were compared on continuous and categorical variables, controlling for diagnosis severity and trait anxiety.

Results

The intervention group had significantly lower state anxiety with State-Trait Anxiety Inventory-state mean scores of 37.3 versus 40.7 in controls (P = 0.03). Intervention group participants were more likely to correctly report their diagnosis (84% vs. 66.3%, P = 0.003). Questionnaire responders were more likely to be in the intervention group and had a higher proportion of cervical intraepithelial neoplasia 2+ pathology. There were no differences in demographics, patient satisfaction, or adherence to follow-up between groups.

Conclusions

Direct delivery of colposcopy results by a trained Nurse Liaison was associated with decreased patient anxiety around colposcopy results, and increased patient knowledge regarding diagnosis. This model may be considered to improve patient-centred care.

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来源期刊

Journal of obstetrics and gynaecology Canada OBSTETRICS & GYNECOLOGY-

CiteScore

3.30

自引率

5.60%

发文量

302

审稿时长

32 days

期刊介绍： Journal of Obstetrics and Gynaecology Canada (JOGC) is Canada"s peer-reviewed journal of obstetrics, gynaecology, and women"s health. Each monthly issue contains original research articles, reviews, case reports, commentaries, and editorials on all aspects of reproductive health. JOGC is the original publication source of evidence-based clinical guidelines, committee opinions, and policy statements that derive from standing or ad hoc committees of the Society of Obstetricians and Gynaecologists of Canada. JOGC is included in the National Library of Medicine"s MEDLINE database, and abstracts from JOGC are accessible on PubMed.