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Impact of a Nurse-Led Chronic Disease Management Intervention Model on Quality of Care and Satisfaction of Maintenance Hemodialysis Patients
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作者 Lanlan Wang Jing Li +3 位作者 Yunxiang Shen Guijun Dai Lingling Guo Chunxiang Zhuang 《Journal of Clinical and Nursing Research》 2024年第5期322-328,共7页
Objective:To explore the impact of a nurse-led chronic disease management model on the quality of care and satisfaction of maintenance hemodialysis patients.Methods:72 patients who received maintenance hemodialysis(MH... Objective:To explore the impact of a nurse-led chronic disease management model on the quality of care and satisfaction of maintenance hemodialysis patients.Methods:72 patients who received maintenance hemodialysis(MHD)from June 2021 to March 2022 were selected to undergo the nurse-led chronic disease management model.The hemodialysis indexes,nutritional status,and the occurrence of adverse events were assessed after 24 weeks of the intervention,and patients’satisfaction was investigated and analyzed.Results:Comparing pre-intervention and after 24 weeks of intervention,urea reduction rate and urea clearance were improved but not statistically different(P>0.05),butβ2-microglobulin was significantly reduced compared with pre-intervention(P<0.05);after 24 weeks of intervention,the effect of decreasing blood calcium,parathyroid hormone,and potassium levels was not obvious(P>0.05),and the level of blood phosphorus decreased significantly compared with pre-intervention(P<0.01),albumin and hemoglobin levels were increased and better than before intervention(P<0.05);after 24 weeks of intervention,the incidence of intradialytic hypotension and hypertension was lower than before intervention(P<0.05),and the total incidence of complications was significantly lower than before intervention(P<0.01);there was no significant difference in the Self-Depression Scale scores after 24 weeks of intervention(P>0.05),and Self-Anxiety Scale scores were significantly lower and better than before intervention(P<0.01).Patient satisfaction was greatly improved,with a statistically significant difference(P<0.05).Conclusion:The chronic disease management intervention model led by specialized nurses is conducive to improving the psychological state and nutritional status of dialysis patients,enhancing the adequacy of dialysis for patients,reducing the incidence of related complications,and ultimately achieving the purpose of improving the quality of life of patients,which has significant clinical value. 展开更多
关键词 Specialized nurse-led intervention Chronic disease management HEMODIALYSIS Dialysis quality
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Effects of a nurse-led heart failure clinic on hospital readmission and mortality in Hong Kong 被引量:6
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作者 Ho Yu Cheng Sek Ying Chair +3 位作者 Qun Wang Janet WH Sit Eliza ML Wong Siu Wai Tang 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2016年第5期415-419,共5页
Background Heart failure (HF) is a physically and socially debilitating disease that carries the burden of hospital re-admission and mortality. As an aging society, Hong Kong urgently needs to find ways to reduce th... Background Heart failure (HF) is a physically and socially debilitating disease that carries the burden of hospital re-admission and mortality. As an aging society, Hong Kong urgently needs to find ways to reduce the hospital readmission of HF patients. This study evaluates the effects of a nurse-led HF clinic on the hospital readmission and mortality rates among older HF patients in Hong Kong. Methods This study is a retrospective data analysis that compares HF patient in a nurse-led HF clinic in Hong Kong compared with HF patients who did not attend the clinic. The nurses of this clinic provide education on lifestyle modification and symptom monitoring, as well as titrate the medications and measure biochemical markers by following established protocols. This analysis used the socio-demographic and clinical data of HF patients who were aged 〉 65 years old and stayed in the clinic over a six-month period. Results The data of a total of 78 HF patients were included in this data analysis. The mean age of the patients was 77.38 ± 6.80 years. Approximately half of the HF patients were male (51.3%), almost half were smokers (46.2%), and the majority received 〈 six years of formal education. Most of the HF patients (87.2%) belonged to classes II and III of the New York Heart Association Functional Classification, with a mean ejection fraction of 47.15± 20.31 mL. The HF patients who attended the clinic (n = 38, 75.13 ± 5.89 years) were significantly younger than those who did not attend the clinic (n = 40, 79.53 ± 6.96 years) (P = 0.04), and had lower recorded blood pressure. No other statistically significant difference existed between the socio-demographic and clinical characteristics of the two groups. The HF patients who did not attend the nurse-led HF clinic demonstrated a significantly higher risk of hospital readmission [odd ratio (OR): 7.40; P 〈 0.01] than those who attended after adjusting for the effect of age and blood pressure. In addition, HF patients who attended the clinic had lower mortality (n = 4) than those who did not attend (n = 14). However, such a difference did not reach statistical significance when the effects of age and blood pressure were adjusted. A signifi- cant reduction in systolic blood pressure IF (2, 94) = 3.39, P = 0.04] and diastolic blood pressure [F (2, 94) = 8.48, P 〈 0.01] was observed among the HF patients who attended the clinic during the six-month period. Conclusions The finding of this study suggests the important role of nurse-led HF clinics in reducing healthcare burden and improving patient outcomes among HF patients in Hong Kong. 展开更多
关键词 Heart failure Hospital readmission MORTALITY nurse-led clinic
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A nurse-led long-term pelvic floor muscle training program in the management of female patients with overactive bladder e A study protocol for a randomized controlled trial 被引量:1
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作者 Tu-Zhen Xu Qiu-Hua Sun +1 位作者 Xiao Huang Bo-Dong Lyu 《International Journal of Nursing Sciences》 2015年第2期158-166,共9页
Background:Previous research has suggested that pelvic floor muscle training(PFMT)offers a therapeutic benefit in patients with overactive bladder.Methods:Weconducted a single-blind,randomized trial of pelvic floor mu... Background:Previous research has suggested that pelvic floor muscle training(PFMT)offers a therapeutic benefit in patients with overactive bladder.Methods:Weconducted a single-blind,randomized trial of pelvic floor muscle training(PFMT)as compared with usual care.The intervention group(n=54)received a 6-month a nurse-led long-term pelvic floor muscle training program(three sessions a day,15e20 times per session)and the control group(n?53)received usual care.All patients received 3-month solifenacin succinate tablets(5 mg e once daily).The treatment outcomes were measured by the Modified Oxford Scale(MOS),Overactive Bladder SymptomScore(OABSS)and the King's Health Questionnaire(KHQ)at baseline,3 months and 6 months respectively.Results:Of the 91 randomly assigned patients,46 patients in the PFMT group and 45 patients in the control group completed the trial.The trial revealed statistically significant differences between groups in pelvic muscle strength at 3 months following the intervention(p<0.05),but no significant difference was found between two groups in OABSS scores(p>0.05).In regards to quality of life,the experimental group showed significant improvements compared to the control group on 6 of 10 domains(p<0.05).At 6 months,there were significant improvements in OABSS scores and quality of life in the experimental group compared to the control group(p<0.05).No adverse events were observed.Conclusion:A nurse-led long-term(6 months)pelvic floor muscle training program may alleviate OAB symptoms effectively and improve the quality of life more than a short term(3 months)pelvic floor muscle training program combined with solifenacin succinate tablets. 展开更多
关键词 nurse-led pelvic floor muscle TRAINING SYMPTOMS Quality of life FEMALE Overactive bladder
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Essentials of Nursing Care in Randomized Controlled Trials of Nurse-Led Interventions in Somatic Care: A Systematic Review 被引量:1
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作者 Bengt Fridlund A.C.Jonsson +11 位作者 E.K.Andersson S-V.Bala G-B.Dahlman A.Forsberg S.Glasdam A.Hommel A.Kristensson C.Lindberg B.Sivberg A.Sjostrom-Strand J.Wihlborg K.Samuelson 《Open Journal of Nursing》 2014年第3期181-197,共17页
Background: Nursing practice has to contribute to evidence pointing out why there is a need for more nurse-designed randomized control trials (RCTs) focusing on evidence-based practice (EBP). How far this EBP has prog... Background: Nursing practice has to contribute to evidence pointing out why there is a need for more nurse-designed randomized control trials (RCTs) focusing on evidence-based practice (EBP). How far this EBP has progressed in different health aspects is usually established by systematic reviews of RCTs. Nurse-led RCTs exist but no study has addressed the essentials of nursing care. Aim: The aim was therefore to determine the essentials of nurses’ interventions by means of nurse-led RCTs in somatic care focusing on the stated context, goals, content, strategies as well as the nurse’s role related to effectiveness. Methods: A systematic review was realized according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data extraction process (n = 55) from PubMed and CINAHL. Results: Of the RCTs in somatic care, 71% showed a positive effectiveness of nurse-led interventions, of which the nurse had a significant role with regard to being the main responsible in 67% of the studies. Also, 47% of the RCTs presented a theoretical standpoint related to the nurse-led interventions and most prominent were international evidence-based guidelines. Goals were found to have either a patient-centered or a professional-centered ambition. Strategies were based on patient-directed initiatives, nurse-patient-directed initiatives or nurse-directed initiatives, while contents were built upon either a patient-nurse interaction or a nursing management plan. Conclusions: This review underlines the necessity of a holistic view of a person, as nurse-led RCTs comprising a patient-centered ambition, patient-directed initiative and patient-nurse interaction plan showed beneficial nursing care effectiveness, particularly if theory-based. In a nurse-led RCT, a basic theoretical perspective is advantageous as well as to elucidate the role of the nurse in relation to the estimated effects. 展开更多
关键词 nurse-led Nursing Care Randomized Controlled Trial Somatic Care Systematic Review
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A Prospective Survey Comparing Patients’ Experience of a Nurse-Led Clinic and Consultant-Led Clinic for Surveillance of Patients with Dilatation of the Intrathoracic Aorta
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作者 Bhuvaneswari Krishnamoorthy Rashmi Birla +1 位作者 William R. Critchley Paul D. Waterworth 《World Journal of Cardiovascular Surgery》 2019年第2期24-34,共11页
Background: Increasing workload in consultant-led clinics often means patients to wait a long time for clinic appointments. To address this, there is an increasing trend in developing nurse-led clinics across many spe... Background: Increasing workload in consultant-led clinics often means patients to wait a long time for clinic appointments. To address this, there is an increasing trend in developing nurse-led clinics across many specialities in the National Health Service. This study aims to assess whether the implementation of a nurse-led clinic in thoracic aortic surgery will optimise the utilisation of health care services and improve overall patient satisfaction. Methods: 80 follow-up patients were asked to complete a questionnaire following their appointment in an aortic clinic, which was led either by a consultant (n = 40) or an aortic specialist nurse (n = 40). All patients seen by a nurse in the clinic were assessed by a consultant surgeon prior to the clinic for suitability. No new patients were seen by a nurse. Any patient with an aortic dimension of 5 cm or greater was seen by the consultant. If there were any complicated clinical features, the patient was seen in the consultant-led clinic. Patients were asked questions about their time spent with the respective health care professionals across 12 categories (punctuality, preparedness, understanding of concerns, clarity of speech, listening, respect, explaining, letting you talk, putting you at ease, emotional support, advice and advice for next follow-up). Patients rated each category using an ordinal scale from 0 - 10. Results: Patient scores were greater in nurse-led clinics compared to consultant-led clinics across a number of categories although only punctuality reached significance (mean 9.2 vs. 6.8, p 0.05). Conclusion: Patients were highly satisfied with the nurse-led clinic across all categories, with greater satisfaction for punctuality. These findings suggest that a nurse-led clinic can be implemented for the management of carefully selected thoracic aortic surgery patient without reduction in patient satisfaction. 展开更多
关键词 nurse-led CLINIC Consultant-Led CLINIC Thoracic Aortic Surgery SURVEILLANCE Patient Satisfaction
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Effects of a Nurse-Led Educational Intervention for Chinese Adult Patients with Psoriatic Arthritis: A Case-Control Study
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作者 Bishan Cai Tiantian Xin +2 位作者 Aizhen Yan Luna Wu Li Wang 《Open Journal of Nursing》 2016年第2期110-114,共5页
The aim of this study was to evaluate the effect of an individual nurse-led educational intervention for patients with psoriatic arthritis (PsA). This was a case-control study. The case group consisted of six individu... The aim of this study was to evaluate the effect of an individual nurse-led educational intervention for patients with psoriatic arthritis (PsA). This was a case-control study. The case group consisted of six individual educational sessions delivered by a nurse. A total of 40 patients with PsA joined in this study: the case group (n = 20) and the control group (n = 18). After a 6-week intervention, the case group had significantly better management for the severity of arthritis symptoms (p < 0.05), better psychological well-being and significant lower levels of anxiety (p < 0.05), and depression score (p < 0.01), and reported better improvement of physical and psychological domain of quality of life (QOL) (both p values < 0.05) than the control group. In conclusion, this nurse-led individual education intervention has statistically significant benefits for the management of clinical symptoms of arthritis and for psychological well-being and QOL in patients with PsA. 展开更多
关键词 nurse-led Interventions Psoriatic Arthristis Chinese Patients Case-Control Study
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Continuing Care for Older Patients During the Transitional Period 被引量:2
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作者 Si-Yuan Wang Yue Zhao Xiao-Ying Zang 《Chinese Nursing Research》 CAS 2014年第1期1-13,共13页
Background: The world is facing increasing pressure with the continuous growth of the older population. Older patients are usually discharged with complex medical problems, high stress and vulnerability, and these fa... Background: The world is facing increasing pressure with the continuous growth of the older population. Older patients are usually discharged with complex medical problems, high stress and vulnerability, and these factors place the elderly at risk for poor outcomes. Purpose: The present review summarizes a method for providing appropriate and affordable health services by nursing professionals to meet older patient's health care needs during their transitional period which is defined as a period from discharge after hospitalization for a major disorder to recovery in a home setting. Summary: Older patients with chronic diseases need seamless health care during a transitional period-a highly stressful and vulnerable period for them. Nurse professionals can conduct decent discharge planning to assist older patients with transitional problems through continuous healthcare. This review summarized the need of continuing care for older patients during the transitional period, the definition of discharge planning, the conceptual framework of discharge planning, and the professionals involved in discharge planning. It also highlighted the problems of discharge planning and follow-up intervention implementation in the mainland of China. Clinical implications: Inadequate discharge planning and follow-up were leading factors associ- ated with the readmission of discharged older patients. Further nursing-led discharge planning should be reinforced in China. 展开更多
关键词 Older patients Continuing care Transitional care MULTIDISCIPLINARY nurse-led ADHERENCE
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Non-Vitamin K Antagonist Oral Anticoagulants: Redefining the Role of the Nurse to Improve Patient Care
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作者 Marlene Robinson 《Open Journal of Nursing》 2015年第12期1142-1157,共16页
Thromboembolic disorders and their associated long-term complications place a burden on patients, healthcare systems and society. Non-vitamin K antagonist (VKA) oral anticoagulants (OACs), including rivaroxaban, dabig... Thromboembolic disorders and their associated long-term complications place a burden on patients, healthcare systems and society. Non-vitamin K antagonist (VKA) oral anticoagulants (OACs), including rivaroxaban, dabigatran, apixaban and edoxaban, are effective for the prevention of stroke in patients with non-valvular atrial fibrillation and for the treatment and secondary prevention of venous thromboembolism. The increasing uptake of the non-VKA OACs in primary care lessens the burden of care and allows for an easier transition of treatment from hospital to home. This transformation in terms of patient management has resulted in the need to empower nurses working in this field to endorse management strategies with a focus on patient education and long-term management (i.e. assessment of compliance, scheduling follow-up visits). Management of both venous thromboembolism and stroke prevention in patients with non-valvular atrial fibrillation requires a multidisciplinary team approach and, looking to the future, nurses are likely to have a key role at the heart of the thrombosis team. This review aims to provide nurses with the confidence to manage patients with thromboembolic disorders, and highlights the importance of responsible non-VKA OAC use and the impact that this can have on improving patient care and outcomes. 展开更多
关键词 Atrial FIBRILLATION Non-VKA OAC nurse-led Management Stroke Prevention Venous THROMBOEMBOLISM
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Nurses’ Role and Experiences as Group-Leaders in a Group Intervention for Women after Gynecological Cancer
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作者 Ragnhild Johanne Tveit Sekse Margrethe Elin Vika 《Open Journal of Nursing》 2016年第3期239-247,共9页
Aim: The aim of this study is to provide insight into nurses’ role and their experiences of leading an education and counselling group intervention for women after gynecological cancer. Methods: A qualitative study, ... Aim: The aim of this study is to provide insight into nurses’ role and their experiences of leading an education and counselling group intervention for women after gynecological cancer. Methods: A qualitative study, based on focus group interview and logs from nurses who led the intervention, was conducted. Findings: The group leaders were touched by the women’s community and were given a deeper understanding of lived experiences after cancer. These insights raised the group-leaders’ understanding of nursing and influenced them to sharpen focus on patient care and priorities in cancer care and follow-up. Being a group-leader meant creating a trusting and secure atmosphere in which the individual woman’s own coping resources was strengthened and empowered. Equally important, the nurses worked continuously and substantially on themselves to build strength and endurance related to situations that called for competent leadership. Conclusion: Being competent in group leadership and having knowledge in the field of cancer are important qualifications for group leaders. Practice Implications: The study shows that nurses gain valuable insight and knowledge about women’s lived experiences of going through gynecological cancer, cancer treatment and rehabilitation. As such, this intervention seems to be educational for nurses, as well as for participants. 展开更多
关键词 Gynecological Cancer Nurses’ Experiences nurse-led Intervention REHABILITATION
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