多学科团队协作的延续护理模式在寻常型银屑病患者中的应用

Application of multidisciplinary teamwork model of continuous care in patients with psoriasis vulgaris

目的探讨以护士为主导的多学科团队协作(MDT)延续护理模式在寻常型银屑病患者中的应用效果。方法选取2019年12月至2020年12月在南方医科大学皮肤病医院银屑病病区接受治疗的96例寻常型银屑病患者,随机分为试验组与对照组,各48例。对照组患者出院后采用以护士主导的传统延续护理模式,试验组患者出院后采用以护士为主导、药师和临床医师共同参与的MDT延续护理模式,随访至出院后6个月,调查两组患者出院时皮损面积和严重程度指数(PASI)、疾病复发率、药物使用依从性、疾病相关知识掌握程度和生活质量。结果出院后6个月,试验组患者较对照组患者PASI评分更低(3.87±1.82比6.43±2.57,t=7.87,P<0.01),疾病复发率更低(10.42%比33.33%,χ^(2)=7.38,P=0.007),药物使用依从性(83.33%比16.67%,χ^(2)=42.67,P<0.05)、疾病相关知识掌握程度(55.13±4.50比47.27±4.37,t=8.68,P<0.01)及生活质量更高(7.67±3.52比10.11±4.21,t=3.08,P=0.003),差异均具有统计学意义。结论在寻常型银屑病患者中应用MDT延续护理模式,能够有效减少患者皮损面积及疾病复发率,提高患者用药依从性和疾病知识掌握程度,最终提高患者生活质量,值得今后在银屑病患者的临床护理中大力推广应用。

Objective To explore the effect of the nurse-led multidisciplinary team(MDT)model of continuous care in patients with psoriasis vulgaris.Methods From December 2019 to December 2020,96 inpatients with psoriasis vulgaris at our hospital were randomly divided into the observation and the control groups,48 patients per group.Following the discharge,the patients in the control group were given the traditional nurse-led continuous care,while the patients in the observation group were given multi-disciplinary team(MDT)model of continuous care,i.e.with the participation of pharmacists and clinicians.Patients in both groups were followed up for 6 months after discharge.Results The 6-month follow-up showed that patients in the observation group had lower PASI scores(3.87±1.82 vs 6.43±2.57,t=7.87,P<0.01),lower relapse rates(10.42%vs 33.33%,χ^(2)=7.38,P=0.007),higher medication compliance(83.33%vs 16.67%,χ^(2)=42.67,P<0.05),better knowledge of the disease(55.13±4.50 vs 47.27±4.37,t=8.68,P<0.01)and better quality of life than patients in the control group(7.67±3.52 vs 10.11±4.21,t=3.08,P=0.003).Conclusions The multidisciplinary teamwork model of continuous care can effectively reduce the area of involved skin and the recurrence rate of the disease in patients with psoriasis vulgaris,in addition to the improvements in patients′medication compliance,knowledge of the disease,as well as patients′quality of life.It is worth to try in the clinical care of psoriatic patients.