自我管理计划对中国慢性病毒性肝炎患者的疗效

StephenW

BMC Nurs. 2019 Sep 18;18:44. doi: 10.1186/s12912-019-0366-7. eCollection 2019.
Efficacy of a self-management program in patients with chronic viral hepatitis in China.
Cui Y1, Moriyama M1, Chayama K2, Liu Y3, Ya C4, Muzembo BA5, Rahman MM6.
Author information

1
    1Department of Chronic Care and Family Nursing, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553 Japan.
2
    2Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553 Japan.
3
    3School of Nursing of Tianjin University of Traditional Chinese Medicine, 88 Yuquan Road, Nankai District, Tianjin, People's Republic of China 300193.
4
    Department of Infection Prevention, Tianjin Second People's Hospital, 75 South Causeway Road, Nankai District, Tianjin, People's Republic of China.
5
    5Department of Public Health, School of Medicine, International University of Health and Welfare, Narita campus 4-3, Kozunomori, Narita-shi, Chiba-ken 286-8686 Japan.
6
    6Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553 Japan.

Abstract
Background:

Chronic hepatitis, mainly B or C, increases the risk of hepatocellular carcinoma and remains an emerging issue in the globe. China has high rates of liver cancer incidence and mortality in the world. To address such challenges, adequate management of chronic hepatitis is required. Self-management education is one alternative for improving the hepatitis patients' knowledge of the disease, mental health, and clinical management.This study aimed to examine the quality of life (QOL), psychological effects, and behavioral changes of a self-management program which allows continuity of care for chronic hepatitis B and C patients.
Method:

In a six-month, randomized controlled trial, we invited 73 chronic hepatitis B/C inpatients to receive (i) two face-to-face education sessions provided by a nurse during hospitalization, and monthly telephone counseling at home after discharge; (ii) or usual care treatment (control group). The primary endpoint (patients' QOL) and secondary outcomes (including self-efficacy, depression symptoms, perceived cognition of illness and behavioral changes) were assessed. In addition, we conducted qualitative data analysis to facilitate the evaluation of the interventions.
Results:

Sixty (82.2%) out of 73 eligible patients with chronic hepatitis B/C (aged 34.9 ± 8.9 years) participated in the study. The intervention group (n = 30) significantly improved on outcomes including QOL, self-efficacy, perceived cognition of illness, and behavioral changes, whereas the control group significantly decreased their healthy behaviors. In terms of behavioral changes, alcohol avoidance, dietary adherence, and stress management also improved in the intervention group. However, there were no significant improvements in symptoms of depression. Most participants (80%) in the intervention group stated that they benefited from the program.
Conclusions:

This program contributed to patients' acquisition of self-management skills to cope with their illnesses, and significantly improved their QOL. This program serves as a reminder for nurses who care for patients with chronic viral hepatitis to acquire these skills as it would help them address the daily needs of their patients.
Trial registration:

UMIN000025378. Registered December 23, 2016.
KEYWORDS:

China; Efficacy; Hepatitis; Patient education; Quality of life; Self-management; Telenursing

PMID:
    31548833
PMCID:
    PMC6749624
DOI:
    10.1186/s12912-019-0366-7

StephenW

BMC护士。 2019年9月18日; 18：44。 doi：10.1186 / s12912-019-0366-7。 eCollection 2019。
自我管理计划对中国慢性病毒性肝炎患者的疗效。
崔Y1，Moriyama M1，Chayama K2，Liu Y3，Ya C4，Muzembo BA5，Rahman MM6。
作者信息

1
1日本广岛市南区霞市1-2-3广岛大学生物医学与健康科学研究科长期护理与家庭护理学系，日本734-8553。
2
2日本广岛市南区霞市1-2-3广岛大学生物医学研究科胃肠病与代谢学系，日本734-8553。
3
3中华人民共和国天津市南开区玉泉路88号天津中医药大学护理学院300193。
4
中华人民共和国天津市南开区高威南道75号天津市第二人民医院感染预防科。
五
日本千叶县成田市小森森市成田大学4-3院，国际卫生福利大学医学院公共卫生系5系286-8686。
6
6日本广岛市南区霞市1-2-3广岛大学生物医学与健康科学研究生院，日本734-8553。

抽象
背景：

慢性乙型肝炎（主要是B型或C型）增加了肝细胞癌的风险，并且仍然是全球范围内一个新兴的问题。中国在世界范围内具有很高的肝癌发病率和死亡率。为了应对这些挑战，需要对慢性肝炎进行适当的管理。自我管理教育是提高肝炎患者对疾病，心理健康和临床管理知识的一种选择。这项研究旨在检查自我管理计划的生活质量（QOL），心理影响和行为改变，该计划可让慢性B和C肝炎患者获得连续的护理。
方法：

在为期六个月的随机对照试验中，我们邀请了73名慢性乙型/丙型肝炎住院患者接受（i）住院期间由护士提供的两次面对面的培训，并在出院后每月在家里进行电话咨询；评估了常规终点治疗（包括QOL组）和次要结局（包括自我效能，抑郁症状，对疾病的感知认知和行为改变）。此外，我们进行了定性数据分析，以轻松评估干预措施。
结果：

在73名合格的慢性乙型肝炎/丙肝患者（年龄34.9±8.9岁）中，有60名（82.2％）加入了研究。干预组（n = 30）在包括生活质量，自我效能感，对疾病的感知认知以及行为改变等方面的结局显着改善，对照组显着降低了他们的健康行为。在行为改变方面，干预组的饮酒避免，饮食依从性和压力管理也有所改善。但是，抑郁症状没有明显改善。干预组中的大多数参与者（80％）表示他们从该计划中受益。
结论：

该计划有助于患者掌握自我管理技能以应对疾病，并显着提高他们的生活质量。该计划提醒那些照顾慢性病毒性肝炎患者的护士掌握这些技能，因为这将帮助他们满足患者的日常需求。
试用注册：

UMIN000025378。 2016年12月23日注册。
关键词：

中国;功效;肝炎;患者教育；生活质量;自我管理;远程护理

乙肝人1949

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