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Evaluation of a nurse-led disease management programme for chronic kidney disease: a randomized controlled trial.

机译:评估由护士主导的慢性肾脏病疾病管理计划:一项随机对照试验。

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BACKGROUND: Patients with end stage renal failure require dialysis and strict adherence to treatment plans to sustain life. However, non-adherence is a common and serious problem among patients with chronic kidney disease. There is a scarcity of studies in examining the effects of disease management programmes on patients with chronic kidney disease. OBJECTIVES: This paper examines whether the study group receiving the disease management programme have better improvement than the control group, comparing outcomes at baseline (O1), at 7 weeks at the completion of the programme (O2) and at 13 weeks (O3). METHODS: This is a randomized controlled trial. The outcome measures were non-adherence in diet, fluid, dialysis and medication, quality of life, satisfaction, symptom control, complication control and health service utilisation. RESULTS: There was no significant difference between the control and study group for the baseline measures, except for sleep. Significant differences (p<0.05) were found between the control and study group at O2 in the outcome measures of diet degree non-adherence, sleep, symptom, staff encouragement, overall health and satisfaction. Sustained effects at O3 were noted in the outcome measures of continuous ambulatory peritoneal dialysis (CAPD) non-adherence degree, sleep, symptom, and effect of kidney disease. CONCLUSIONS: Many studies exploring chronic disease management have neglected the group with end stage renal failure and this study fills this gap. This study has employed an innovative model of skill mix using specialist and general nurses and demonstrated patient improvement in diet non-adherence, CAPD non-adherence, aspects of quality of life and satisfaction with care. Redesigning chronic disease management programmes helps to optimize the use of different levels of skills and resources to bring about positive outcomes.
机译:背景:患有晚期肾衰竭的患者需要透析并严格遵守治疗计划以维持生命。然而,在慢性肾脏病患者中,不依从性是一个普遍而严重的问题。在检查疾病管理计划对慢性肾脏病患者的影响方面缺乏研究。目的:本文比较了接受疾病管理计划的研究组是否比对照组有更好的改善,比较了基线(O1),完成计划(O2)的第7周和第13周(O3)的结果。方法:这是一项随机对照试验。结果指标是饮食,液体,透析和用药,生活质量,满意度,症状控制,并发症控制和卫生服务利用的不依从性。结果:除睡眠外,基线水平的对照组和研究组之间无显着差异。在饮食程度不坚持,睡眠,症状,工作人员鼓励,整体健康和满意度的结局指标中,O2对照组和研究组之间存在显着差异(p <0.05)。在连续非卧床腹膜透析(CAPD)的不粘连程度,睡眠,症状和肾脏疾病影响的预后指标中,O3的持续作用得到了证实。结论:许多探索慢性疾病管理的研究都忽略了终末期肾衰竭的人群,这项研究填补了这一空白。这项研究采用了由专业护士和普通护士组成的创新技能组合模型,并证明了患者在饮食不依从,CAPD不依从,生活质量和护理满意度方面的改善。重新设计慢性病管理计划有助于优化使用不同水平的技能和资源,以带来积极的成果。

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