基于NICE指南的姑息护理在心力衰竭终末期患者中的应用

Effects of NICE guideline based palliative care in end-stage heart failure patients

目的探讨基于NICE指南的姑息护理在心力衰竭终末期患者中的应用效果。方法采用方便抽样法,选取2016年10月-2017年5月在郑州市某三级甲等医院心血管内科4个病区住院的终末期心力衰竭患者为研究对象。将1 ~3病区患者设为试验组(n=143), 4病区患者设为对照组(n=135)。对照组实施常规姑息护理,试验组在此基础上参照NICE指南要求进行个性化姑息护理。干预4周后采用中文版姑息照护结局量表(POS)和生活质量12条简表第2版(SF-12v2)比较干预效果。结果干预4周后,试验组患者POS总分低于对照组,差异有统计学意义(P<0.01);试验组患者SF-12v2生理总分和心理总分均高于对照组,差异有统计学意义(P<0.01)。结论基于NICE指南的姑息护理干预减轻了患者及家属的焦虑状况,提高了患者的生活质量。

Objective To explore the effects of National Institute for Health and Care Excellence (NICE) Guideline based palliative care in end-stage heart failure patients. Methods From October 2016 to May 2017, we selected end-stage heart failure patients from four wards of cardiovascular department at a Class Ⅲ Grade A hospital in Zhengzhou as subjects by convenience sampling. Patients from the first to the third ward were in experimental group (n=143), and those from the fourth ward were in control group (n=135). Control group carried out routine palliative care. On the basis of that in control group, experimental group adopted individual palliative care according to the National Institute for Health and Care Excellence (NICE) guideline. Four months after intervention, we compared the intervention effects with the Chinese version of palliative care outcome scale (POS) and the medical outcomes study short form 12-item version 2 (SF-12v2). Results Four months after intervention, the total score of POS of patients in experimental group was lower than that in control group with a statistical difference (P < 0.01). The total scores of physical and mental health of SF-12v2 of patients in experimental group were higher than those in control group with statistical differences (P < 0.01). Conclusions NICE guideline based palliative care can reduce the anxiety of patients and their family members, and can improve quality of life of patients.