Nurse-led clinics

  • 文章类型: Journal Article
    目的:探讨围手术期护士主导的咨询干预对未满足需求的影响。结直肠癌患者的性功能和生活质量。
    方法:这项准实验研究包括82例接受结直肠癌手术的患者(对照n=45,干预n=37)。基于电话的围手术期护士主导的咨询干预,其中包含实施,后续行动,和评估,从手术前开始到手术后第3个月。数据是用癌症幸存者未满足需求量表收集的,欧洲癌症治疗和研究组织生活质量量表-30,结肠直肠-29,女性性功能指数,和国际勃起功能指数术前和术后第3-6个月。控制数据是在大流行之前收集的,以及整个大流行期间的干预组。Mann-Whitney-U,使用Wilcoxon秩检验。
    结果:与对照组相比,干预组患者报告较低的未满足和总需求得分(p=0.000);较高的生活质量(p=0.000),物理,情绪(p=0.000),角色(p=0.001),和社会功能得分(p=0.002);较低的疲劳(p=0.000),便秘(p=0.034),疼痛(p=0.018),恶心呕吐(p=0.004),失眠得分(p=0.003);和更高的身体形象,焦虑(p=0.000)和体重评分(p=0.003),下尿频臀部疼痛(p=0.000),排尿困难(p=0.001),腹痛(p=0.001),波动(p=0.000),大便频率(p=0.002),6个月时大便失禁(p=0.006)评分(p<0.05)。男女性功能评分差异无统计学意义(p>0.05)。
    结论:围手术期护士主导的咨询减少了未满足的需求,并通过降低症状水平提高了整体生活质量,但不影响结直肠癌手术患者的性健康结局。
    OBJECTIVE: To investigate the effect of perioperative nurse-led counselling intervention on unmet needs, sexual function and quality of life in colorectal cancer patients.
    METHODS: This quasi-experimental study included 82 patients who underwent colorectal cancer surgery (control n = 45, intervention n = 37). The telephone-based perioperative nurse-led counselling intervention, which contained implementation, follow-up, and assessment, was applied to start from pre-surgery to post-surgery 3rd month. Data were collected with the Unmet Needs of Cancer Survivors Scale, European Organisation for Treatment and Research of Cancer Quality of Life Scale-30, Colorectal-29, Female Sexual Function Index, and International Index of Erectile Function pre- and post-surgery 3rd-6th months. The control data was collected before the pandemic, and the intervention group throughout the pandemic. The Mann-Whitney-U, Wilcoxon rank test was used.
    RESULTS: Compared to the control group, intervention group patients reported lower unmet and total needs scores (p = 0.000); higher quality of life (p = 0.000), physical, emotional (p = 0.000), role (p = 0.001), and social functioning scores (p = 0.002); lower fatigue (p = 0.000), constipation (p = 0.034), pain (p = 0.018), nausea-vomiting (p = 0.004), and insomnia scores (p = 0.003); and higher body image, anxiety (p = 0.000) and weight scores (p = 0.003), lower urinary frequency buttock pain (p = 0.000), dysuria (p = 0.001), abdominal pain (p = 0.001), fluctuance (p = 0.000), stool frequency (p = 0.002), and faecal incontinence (p = 0.006) scores at the sixth month (p < 0.05). There were no statistically significant differences between male and female sexual function scores (p > 0.05).
    CONCLUSIONS: Perioperative nurse-led counselling reduced unmet needs and increased the overall quality of life by decreasing symptom levels but did not affect sexual health outcomes in patients with colorectal cancer surgery.
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  • 文章类型: Journal Article
    目的:评估护士主导的电话随访服务在某三级儿科医院儿童睡眠呼吸紊乱(SDB)/阻塞性睡眠呼吸暂停(OSA)手术后的效果和患者满意度。
    方法:前瞻性观察性对照研究。
    方法:2015年6月至2018年6月期间,16岁以下儿童接受腺样体和/或扁桃体手术治疗SDB或OSA。术后六周,耳鼻喉科护士专家通过电话与父母联系。T-14问卷用于评估术后结果。随后,家长被要求评估他们在2016年6月至2017年4月期间接受护士主导的电话咨询服务的经历。
    结果:535例患者的平均术后T-14评分为2.13(95%CI1.7-2.5)。430例患者在护士主导的电话咨询后出院,术后平均T-14评分为1.0(95%CI0.8-1.2)。随后对105例患者进行了临床检查,平均T-14评分为6.88(95%CI5.25-8.51)。36例(6.7%)患者有持续的SDB或OSA症状。55名家长被邀请对护士主导的电话FU诊所进行评估,对服务的满意度为100%。
    结论:以护士为主导的电话随访服务是有效和安全的,家长满意度高。它减少了对无并发症患者的不必要随访,同时为有持续问题的患者提供了强大的安全网。
    OBJECTIVE: To assess the effectiveness and patient satisfaction of a nurse-led telephone follow-up service in children following surgery for sleep disordered breathing (SDB)/obstructive sleep apnoea (OSA) in a tertiary paediatric hospital.
    METHODS: Prospective observational uncontrolled study.
    METHODS: Children under the age of 16 undergoing adenoid and/or tonsil surgery between June 2015 and June 2018 for SDB or OSA. Parents were contacted by telephone six weeks post-operatively by an ENT nurse specialist. The T-14 questionnaire was utilised to assess post-operative outcomes. Parents were subsequently asked to evaluate their experience of this nurse-led telephone consultation service between June 2016 and April 2017.
    RESULTS: 535 patients were included with an average post-operative T-14 score of 2.13 (95% CI 1.7-2.5). 430 patients were discharged following the nurse-led telephone consultation with a mean post-operative T-14 score 1.0 (95% CI 0.8-1.2). 105 patients were subsequently reviewed in clinic with an average T-14 score of 6.88 (95% CI 5.25-8.51). 36 (6.7%) patients had ongoing symptoms of SDB or OSA. 55 parents were invited to provide an evaluation of the nurse-led telephone FU clinic, which showed a 100% satisfaction rate with the service.
    CONCLUSIONS: A nurse-led telephone follow-up service is efficient and safe with high levels of parental satisfaction. It reduces unnecessary follow-up of uncomplicated patients whilst providing a robust safety net for those with ongoing problems.
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  • 文章类型: Journal Article
    背景:需要门诊化疗的患者人数逐年增加,在门诊诊所和化疗单位造成能力问题。尽管已经建立了由护士主导的化疗诊所来解决这个问题,缺乏对其有效性的评估。尽管肿瘤学中护理角色和职责的发展迅速扩大,在护士主导的诊所中,对护士角色的操作方面了解甚少。
    目的:探讨护士在护士主导的化疗诊所中的角色。
    方法:对护士主导的化疗诊所中护士角色的重点人种学研究,包括对护士的半结构化访谈。
    方法:英国的四个化疗单位/癌症中心参与者:目的抽样用于选择英国护士主导的化疗诊所内不同地理区域的四个癌症中心/单位。参与者是在选定地点的护士领导的化疗诊所工作的13名护士。
    方法:护士主导化疗门诊的非参与者观察,与护士参与者的半结构化访谈,临床方案和相关文件的审查。
    结果:对13名护士进行了61次护患咨询,其中对11名护士进行了访谈。尽管在临床技能培训和处方方面有相似之处,化疗护士经营的诊所和高级护士经营的诊所之间存在很大差异。这包括在每个诊所看到的患者数量,操作方面,护士的自主权,实践范围和临床决策能力。差异突出四个不同级别的护士主导化疗诊所,基于护士的自主性和临床实践范围。然而,这受到医疗顾问的严重影响。几位护士认为他们正在进行整体评估,然而,他们使用的是医学模型/咨询方式,表明护士角色的医学化。
    结论:确定了四个不同级别的护士主导化疗诊所,说明护士角色的差异。尽管诊所由护士管理,但它们通常由医疗顾问控制,这会降低护士的自主性,并对患者护理产生负面影响。
    BACKGROUND: The number of patients requiring ambulatory chemotherapy is increasing year on year, creating problems with capacity in outpatient clinics and chemotherapy units. Although nurse-led chemotherapy clinics have been set up to address this, there is a lack of evaluation of their effectiveness. Despite a rapid expansion in the development of nursing roles and responsibilities in oncology, there is little understanding of the operational aspects of nurses\' roles in nurse-led clinics.
    OBJECTIVE: To explore nurses\' roles within nurse-led chemotherapy clinics.
    METHODS: A focused ethnographic study of nurses\' roles in nurse-led chemotherapy clinics, including semi-structured interviews with nurses.
    METHODS: Four chemotherapy units/cancer centres in the UK PARTICIPANTS: Purposive sampling was used to select four cancer centres/units in different geographical areas within the UK operating nurse-led chemotherapy clinics. Participants were 13 nurses working within nurse-led chemotherapy clinics at the chosen locations.
    METHODS: Non-participant observation of nurse-led chemotherapy clinics, semi-structured interviews with nurse participants, review of clinic protocols and associated documentation.
    RESULTS: 61 nurse-patient consultations were observed with 13 nurses; of these 13, interviews were conducted with 11 nurses. Despite similarities in clinical skills training and prescribing, there were great disparities between clinics run by chemotherapy nurses and those run by advanced nurse practitioners. This included the number of patients seen within each clinic, operational aspects, nurses\' autonomy, scope of practice and clinical decision-making abilities. The differences highlighted four different levels of nurse-led chemotherapy clinics, based on nurses\' autonomy and scope of clinical practice. However, this was heavily influenced by medical consultants. Several nurses perceived they were undertaking holistic assessments, however they were using medical models/consultation styles, indicating medicalization of nurses\' roles.
    CONCLUSIONS: Four different levels of nurse-led chemotherapy clinics were identified, illustrating disparities in nurses\' roles. Although clinics are run by nurses they are often controlled by medical consultants, which can reduce nurses\' autonomy and negatively impact on patient care.
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