{"title":"基于 5As 模型的过渡护理计划对主动脉瓣置换术后 B 型主动脉夹层中国患者的疗效：随机对照试验。","authors":"Jianxin Tu, Jing Zhou, Xiumao Li, Qin Zhang, Mingxian Luo, Jiamei Zhou","doi":"10.31083/j.rcm2509347","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Thoracic aortic endovascular repair (TEVAR) is the primary treatment for Stanford type B aortic dissection (type B AD). However, patients often encounter significant difficulties post-TEVAR that endanger their safety when transitioning from hospital- to home-based care. Moreover, information on the ideal transitional care for patients with type B AD post-TEVAR is scarce in China. This single-masked randomized clinical trial aimed to assess the effectiveness of the Assess, Advise, Agree, Assist, and Arrange (5As) model-based transitional care in improving discharge preparation level and transitional care quality post-TEVAR among patients with type B AD in China.</p><p><strong>Methods: </strong>This study was conducted at a hospital in China between January 2021 and October 2021. Patients with type B AD were randomly divided into intervention and control groups. Participants in the intervention group received the 5As model-based transitional nursing care. The 5As model is an evidence-based intervention strategy comprising: (1) Assess: assessing the preoperative cardiovascular risk behavior of patients with AD. (2) Advise: making suggestions according to the risk behaviors of the patients. (3) Agree: reaching a consensus on goals and action plans by making decisions with the patients and their families. (4) Assist: assisting patients in solving obstacles to implementing health plans. (5) Arrange: arranging follow-up visits according to the actual situation of the patients and guiding them in adhering to a schedule. The control group received the usual nursing care for the same duration and number of follow-up visits. A trained research nurse collected all the baseline data of the patients on admission, assessed discharge readiness level (using the Readiness for Hospital Discharge Scale) on the day of discharge, and collected transitional quality of care (by the Care Transition Measure-15) data on day 30 after discharge.</p><p><strong>Results: </strong>Overall, 72 patients with type B AD were recruited. Discharge readiness level and transitional care quality in the intervention group were significantly superior to those in the control group.</p><p><strong>Conclusions: </strong>This study showed that the 5As model-based transitional care program can effectively promote discharge readiness and transitional care quality of patients with type B AD post-TEVAR.</p><p><strong>Clinical trial registration: </strong>The Chinese Clinical Trial Registry Center: ChiCTR2200060797 (https://www.chictr.org.cn/showproj.html?proj=167403).</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440392/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of the 5As Model-Based Transitional Care Program among Chinese Patients with Type B Aortic Dissection Post-TEVAR: A Randomized Controlled Trial.\",\"authors\":\"Jianxin Tu, Jing Zhou, Xiumao Li, Qin Zhang, Mingxian Luo, Jiamei Zhou\",\"doi\":\"10.31083/j.rcm2509347\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Thoracic aortic endovascular repair (TEVAR) is the primary treatment for Stanford type B aortic dissection (type B AD). However, patients often encounter significant difficulties post-TEVAR that endanger their safety when transitioning from hospital- to home-based care. Moreover, information on the ideal transitional care for patients with type B AD post-TEVAR is scarce in China. This single-masked randomized clinical trial aimed to assess the effectiveness of the Assess, Advise, Agree, Assist, and Arrange (5As) model-based transitional care in improving discharge preparation level and transitional care quality post-TEVAR among patients with type B AD in China.</p><p><strong>Methods: </strong>This study was conducted at a hospital in China between January 2021 and October 2021. Patients with type B AD were randomly divided into intervention and control groups. Participants in the intervention group received the 5As model-based transitional nursing care. The 5As model is an evidence-based intervention strategy comprising: (1) Assess: assessing the preoperative cardiovascular risk behavior of patients with AD. (2) Advise: making suggestions according to the risk behaviors of the patients. (3) Agree: reaching a consensus on goals and action plans by making decisions with the patients and their families. (4) Assist: assisting patients in solving obstacles to implementing health plans. (5) Arrange: arranging follow-up visits according to the actual situation of the patients and guiding them in adhering to a schedule. The control group received the usual nursing care for the same duration and number of follow-up visits. 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引用次数: 0
摘要
背景：胸主动脉血管内修复术（TEVAR）是治疗斯坦福B型主动脉夹层（B型AD）的主要方法。然而，TEVAR术后患者在从医院过渡到家庭护理时往往会遇到严重困难，危及他们的安全。此外，关于B型主动脉夹层患者TEVAR术后理想过渡护理的信息在中国也非常缺乏。这项单掩蔽随机临床试验旨在评估基于评估、建议、同意、协助和安排（5As）模式的过渡性护理在提高中国B型AD患者出院准备水平和TEVAR术后过渡性护理质量方面的效果：本研究于 2021 年 1 月至 2021 年 10 月在中国一家医院进行。B 型 AD 患者被随机分为干预组和对照组。干预组的参与者接受基于5As模式的过渡性护理。5A模式是一种循证干预策略，包括：（1）评估：评估AD患者术前心血管风险行为。(2）建议：根据患者的风险行为提出建议。(3) 同意：通过与患者及其家属共同决策，就目标和行动计划达成共识。(4) 协助：协助患者解决实施健康计划的障碍。(5) 安排：根据病人的实际情况安排随访，并指导他们遵守时间表。对照组接受常规护理，随访时间和次数相同。训练有素的研究护士收集患者入院时的所有基线数据，在出院当天评估出院准备程度（使用出院准备程度量表），并在出院后第30天收集过渡护理质量（使用护理过渡测量-15）数据：共招募了 72 名 B 型 AD 患者。干预组的出院准备水平和过渡护理质量明显优于对照组：该研究表明，基于5As模式的过渡性护理方案能有效促进TEVAR术后B型AD患者的出院准备水平和过渡性护理质量：临床试验注册：中国临床试验注册中心：临床试验注册：中国临床试验注册中心：ChiCTR2200060797 (https://www.chictr.org.cn/showproj.html?proj=167403)。
Effectiveness of the 5As Model-Based Transitional Care Program among Chinese Patients with Type B Aortic Dissection Post-TEVAR: A Randomized Controlled Trial.
Background: Thoracic aortic endovascular repair (TEVAR) is the primary treatment for Stanford type B aortic dissection (type B AD). However, patients often encounter significant difficulties post-TEVAR that endanger their safety when transitioning from hospital- to home-based care. Moreover, information on the ideal transitional care for patients with type B AD post-TEVAR is scarce in China. This single-masked randomized clinical trial aimed to assess the effectiveness of the Assess, Advise, Agree, Assist, and Arrange (5As) model-based transitional care in improving discharge preparation level and transitional care quality post-TEVAR among patients with type B AD in China.
Methods: This study was conducted at a hospital in China between January 2021 and October 2021. Patients with type B AD were randomly divided into intervention and control groups. Participants in the intervention group received the 5As model-based transitional nursing care. The 5As model is an evidence-based intervention strategy comprising: (1) Assess: assessing the preoperative cardiovascular risk behavior of patients with AD. (2) Advise: making suggestions according to the risk behaviors of the patients. (3) Agree: reaching a consensus on goals and action plans by making decisions with the patients and their families. (4) Assist: assisting patients in solving obstacles to implementing health plans. (5) Arrange: arranging follow-up visits according to the actual situation of the patients and guiding them in adhering to a schedule. The control group received the usual nursing care for the same duration and number of follow-up visits. A trained research nurse collected all the baseline data of the patients on admission, assessed discharge readiness level (using the Readiness for Hospital Discharge Scale) on the day of discharge, and collected transitional quality of care (by the Care Transition Measure-15) data on day 30 after discharge.
Results: Overall, 72 patients with type B AD were recruited. Discharge readiness level and transitional care quality in the intervention group were significantly superior to those in the control group.
Conclusions: This study showed that the 5As model-based transitional care program can effectively promote discharge readiness and transitional care quality of patients with type B AD post-TEVAR.
Clinical trial registration: The Chinese Clinical Trial Registry Center: ChiCTR2200060797 (https://www.chictr.org.cn/showproj.html?proj=167403).
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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