AF-EduCare和AF-EduApp方法提高心房颤动患者房颤知识和危险因素认知的有效性:一项随机对照试验

Lieselotte Knaepen, Lien Desteghe, Michiel Delesie, Rana Önder, Johan Vijgen, Paul Dendale, Joris Ector, Hein Heidbuchel
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引用次数: 0

摘要

目的:考虑到不同的治疗策略,开发心房颤动(AF)患者的综合护理途径至关重要。此外,对病情的了解是使患者参与其护理的重要因素。患者教育是AF-EduCare/AF-EduApp一体化方法的核心。本文的主要目的是报告这种方法对房颤和危险因素(RF)相关知识和自我保健意识的影响。方法和结果:房颤患者(n = 1232)随机接受标准治疗(SC)或三种教育干预:面对面、在线或基于app的教育。干预组患者根据不同时间点的洁莎心房颤动知识问卷(JAKQ)和自我保健问卷(SCQ)的回答进行针对性教育。接受教育随访的患者知识得分显著高于对照组(面对面:86.5±13.2%;在线:82.5%±19.3%;app组:80.1±15.0%)高于SC组(65.3±16.6%)(P < 0.001)。在第一阶段(即3个月),知识迅速提高,并在所有教育组中保持持续。基线时RF患者通过教育对其RF的认识略有但显著增加[例如,不知道教育与SC之间上次测量的收缩压的比较:比值比为0.45 (P = 0.012)], SC患者未见这种变化。然而,与病历中的客观记录(如高血压)相比,患者一直低估自己的RFs的存在。结论:JAKQ和SCQ是在日常临床护理中对房颤患者进行有针对性教育的良好工具。临床知识水平显著提高,但对个人危险因素认识的影响仍不理想。注册:ClinicalTrials/gov: NCT03707873NCT03788044。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness of the AF-EduCare and AF-EduApp approach to improve atrial fibrillation knowledge and risk factor awareness in patients with atrial fibrillation: a randomized controlled trial.

Aims: Developing an integrated care pathway for atrial fibrillation (AF) patients is of pivotal importance, given the different treatment strategies. Moreover, knowledge about the condition is an important factor in engaging patients in their care. Patient education formed the core of the integrated AF-EduCare/AF-EduApp approach. The main aim of this manuscript is to report the impact of this approach on AF and risk factor (RF)-related knowledge and self-care awareness.

Methods and results: Atrial fibrillation patients (n = 1232) were randomized to standard care (SC) or three educational interventions: in-person, online, or app-based education. Patients in the intervention groups received targeted education based on their responses to the Jessa Atrial fibrillation Knowledge Questionnaire (JAKQ) and a Self-Care Questionnaire (SCQ) presented at different time points. Patients who received educational follow-up reached a significantly higher knowledge score (in-person: 86.5 ± 13.2%; online: 82.5 ± 19.3%; app: 80.1 ± 15.0%) than the SC group (65.3 ± 16.6%) after 12/18 months (P < 0.001). The knowledge rapidly improved with the first sessions (i.e. 3 months) and remained sustained in all education groups. Patients with RF at baseline showed a slight but significant increase in awareness about their RF through education [e.g. no knowledge of last measured systolic blood pressure compared between education vs. SC: odds ratio of 0.45 (P = 0.012)], a change that was not seen in SC patients. Nevertheless, patients keep under-estimating the presence of their own RFs compared with objective documentation in their medical record (e.g. hypertension).

Conclusion: The JAKQ and SCQ are good instruments to provide targeted education to AF patients in daily clinical care. Knowledge level increases clinically significantly, but the impact on awareness about personal risk factors remains unsatisfactory.

Registration: ClinicalTrials/gov: NCT03707873NCT03788044.

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