Illness beliefs

  • 文章类型: Journal Article
    治疗后,癌症幸存者经常经历疼痛,对他们的生活质量产生负面影响。尽管焦虑和对癌症复发(FCR)的恐惧都被证明会加剧疼痛干扰,关于焦虑/FCR与疼痛干扰之间的时间关系或可改变的认知/情绪因素之间可能缓和癌症幸存者之间的关系的了解较少。这项纵向研究旨在提高我们对原发性癌症治疗后焦虑和FCR对随后的疼痛干扰的影响的理解。我们还检查了潜在的可修改的主持人(即,与癌症相关的疾病信念和情绪调节困难)焦虑/FCR与随后的疼痛干扰之间的关系。成人(N=397;67%女性;Mage=59.1岁)诊断为乳腺,结直肠,或前列腺癌在基线(治疗完成后平均2.5个月)和6个月随访时完成自我报告测量.更大的焦虑和FCR不仅可以预测随后的疼痛干扰,但也预测随着时间的推移疼痛干扰会增加。此外,在焦虑和疼痛干扰的潜在调节者之间观察到复杂的相互作用模式。具体来说,对于焦虑/FCR水平较低的患者,较低的个人控制信念和较高的后果信念与较大的疼痛干扰相关.情绪调节困难也缓和了焦虑-疼痛干扰环节(即,在较低的焦虑水平下,与更大的疼痛干扰密切相关),但不是FCR-疼痛链接。慢性信念在预测疼痛干扰时与焦虑或FCR没有相互作用。这项研究促进了我们对焦虑/FCR对疼痛干扰的作用的理解,以及对癌症治疗后长期疼痛风险更大的个体的潜在心理治疗目标。
    Following treatment, cancer survivors often experience pain that negatively impacts their quality of life. Although both anxiety and fear of cancer recurrence (FCR) have been shown to exacerbate pain interference, less is known about either the temporal relationship between anxiety/FCR and pain interference or modifiable cognitive/emotional factors that might moderate that relationship among cancer survivors. This longitudinal study aims to advance our understanding of the impact of both anxiety and FCR following primary cancer treatment on subsequent pain interference. We also examined potentially modifiable moderators (i.e., cancer-related illness beliefs and emotion regulation difficulties) of the relationship between anxiety/FCR and subsequent pain interference. Adults (N = 397; 67% female; Mage = 59.1 years) diagnosed with breast, colorectal, or prostate cancer completed self-report measures at baseline (average of 2.5 months following treatment completion) and at 6-month follow-up. Both greater anxiety and FCR not only predicted subsequent pain interference, but also predicted increases in pain interference over time. Additionally, complex interaction patterns were observed between anxiety and the potential moderators on pain interference. Specifically, lower Personal Control beliefs and higher Consequences beliefs were associated with greater pain interference for those with lower levels of anxiety/FCR. Emotion regulation difficulties also moderated the anxiety-pain interference link (i.e., was more strongly associated with greater pain interference at lower levels of anxiety), but not the FCR-pain link. Chronicity beliefs did not interact with anxiety or FCR in predicting pain interference. This study advances our understanding of the role of anxiety/FCR on pain interference over time as well as potential psychological treatment targets for individuals at greater risk for longer-term pain following cancer treatment.
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  • 文章类型: Journal Article
    目的:本研究旨在描述护士对家庭在护理中的重要性的态度和信念,并探讨不同医疗机构之间护士对以家庭为中心的护理的态度和信念的差异。例如社区医疗中心和医院。
    背景:家庭显著影响个体的福祉和健康。因此,护士应支持家庭参与护理。近年来,家庭护理研究强调了在医疗机构继续教育中教授家庭护理技能的重要性。研究表明,认为疾病关系到整个家庭的护士更有可能让家人参与病人护理。
    方法:采用横断面研究设计。
    方法:数据是在2019年3月至9月的一个时间点从首都地区初级卫生保健中心(n=112)和冰岛大学医院临床工作的425名护士(n=313)收集的。
    结果:主要研究结果表明,在大学医院妇女和儿童部门工作的护士报告说,与在重症监护或外科病房工作的护士相比,在患者护理中对家庭发展的态度明显更积极。对于在医疗中心工作的护士来说,护士对家属参与病人护理的态度也有显著差异。与在婴幼儿健康促进部门工作的护士相比,在家庭护理中工作的护士的态度要积极得多。
    结论:医疗保健提供者和家庭之间需要加强合作,以提高护理质量和健康相关结果。因此,在患者护理期间,提高护士对家庭重要性的认识至关重要。
    结论:本研究旨在描述护士对家庭护理的态度和信念。不同单位的护士态度存在差异,而不是机构。
    OBJECTIVE: This study aimed to describe nurses\' attitudes and beliefs towards the importance of family in nursing care and explore differences in nurses\' attitudes and beliefs towards family-centered care between different healthcare institutions, such as community healthcare centers and hospitals.
    BACKGROUND: Family significantly affects the well-being and health of individuals. Therefore, nurses should support family engagement in nursing care. In recent years, family nursing research has emphasized the importance of teaching family nursing skills in continued education in healthcare institutions. Research has indicated that nurses who believe that illness concerns the family as a whole are more likely to involve the family in patient care.
    METHODS: A cross-sectional research design was used.
    METHODS: Data were collected at one timepoint between March and September 2019 from 425 nurses working at the Primary Health Care Centers of the Capital Area (n=112) and in clinical settings at the University Hospital in Iceland (n=313).
    RESULTS: The main findings indicated that nurses working in the women-and-child division at the University Hospital reported significantly more positive attitudes towards family evolvement in patient care than nurses working in the intensive care or surgical units. For nurses working at healthcare centers, a significant difference was also found in the nurses\' attitudes towards involving families in patient care. The nurses who were working in home care had significantly more positive attitudes when compared to those working in the infant and young children health promotion units.
    CONCLUSIONS: Greater collaboration is required between healthcare providers and families to improve the quality of care and health-related outcomes. Therefore, it is crucial to enhance nurses\' knowledge about the importance of families during patient care.
    CONCLUSIONS: This study aimed to describe nurses\' attitudes and beliefs towards family care. Differences were found between nurse\'s attitudes by units but not by institutions.
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  • 文章类型: Journal Article
    背景:在全球范围内,经济发达国家面临着类似的老龄化人口结构和“护理差距”的挑战,然而,由于不同的护理和正式的支持系统,以及围绕疾病和护理的不同文化和社会规范。这项探索性研究的目的是研究照顾者动机的跨国差异,意愿,值,生活的意义,疾病信念,和幸福的经历,增益,与健康相关的生活质量,负担和抑郁,6个欧洲国家和以色列。很少描述上述非正式照料者经历中的跨国差异。
    方法:进行了一项在线调查(ENTWINE-iCohort),尽可能使用经过验证的措施。本文利用了来自879名护理人员和7个国家的数据(希腊,意大利,荷兰,波兰,瑞典,英国,和以色列)。
    结果:没有一致的发现支持照顾者支持政策/国家文化与照顾者动机/意愿之间的并发关系。通常以个人主义文化为特征的国家的看护人报告家庭主义较低,更高的自我增强值,与更多的集体主义国家相比,更大的疾病威胁。在较贫穷的国家中,对意义的追求要高于较富裕的国家。较高的负面照顾者体验(例如,负担)和较低的积极体验(例如,与正规支持系统较发达的国家相比,在护理人员支持不足的国家通常观察到福祉)。
    结论:跨国差异可以在不同程度上由围绕护理(或其缺失)和国家文化背景的国家政策来解释。结果强调了正式支持服务对于实现积极的照顾者体验的重要性,并帮助制定政策和措施,以支持欧洲和以色列的护理人员。
    BACKGROUND: Globally, economically developed countries face similar ageing demographics and the challenge of a \'care gap\', yet they vary due to different care and formal support systems, and different cultural and societal norms around illness and care. The aim of this exploratory study was to examine cross-country variations in caregiver motivations, willingness, values, meaning in life, illness beliefs, and experiences of wellbeing, gain, health-related quality of life, burden and depression, across 6 European countries and Israel. Cross-country differences in the above-mentioned informal caregiver experiences are rarely described.
    METHODS: An online survey (ENTWINE-iCohort) was conducted using validated measures wherever possible. This paper utilises data from 879 caregivers and seven countries (Greece, Italy, the Netherlands, Poland, Sweden, the UK, and Israel).
    RESULTS: No consistent finding supporting the concurrent relationship between caregiver support policies/country culture and caregiver motivations/willingness was found. Caregivers in countries typically characterised by individualist cultures reported lower familism, higher self-enhancement values, and greater perceived illness threat compared to more collectivist countries. Search for meaning was higher in poorer countries than in wealthier countries. Higher negative caregiver experiences (e.g., burden) and lower positive experiences (e.g., wellbeing) were generally observed in countries with underdeveloped caregiver support as compared to countries with more developed formal support systems.
    CONCLUSIONS: Cross-country variations can be explained to varying degrees by national policies around care (or their absence) and country cultural contexts. The results emphasise the importance of formal support services for achieving positive caregiver experiences, and help inform the development of policies and measures to support caregivers in Europe and Israel.
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  • 文章类型: Journal Article
    间歇性跛行是外周动脉疾病(PAD)最常见的症状,并且与步行障碍导致的生活质量(QoL)下降有关。归因于该疾病的威胁水平影响QoL和身体活动。这项研究探索了信念和疾病图,以及它们与接受PAD保守治疗的患者的生活质量和身体活动的关系。进行了一项横断面研究,包括119例PAD和间歇性跛行患者,其中患者被要求自由绘制他们的疾病,33人同意参加。关于PAD的信念的特征是威胁程度低。相信疾病的情绪影响,关于疾病后果的陈述和对疾病的关注与生活质量恶化有关;对疾病有高度个人控制的信念与更多的身体活动有关。对疾病图的分析揭示了三类:疾病的扩展(类别1),疾病的位置和表现(类别2),以及图纸的详细程度和复杂性(类别3)。更大的疾病程度与更多的疾病症状(IPQ6)相关(rs=0.399,p=.021)。在咨询PAD患者时,有必要解决有关该疾病的信念和陈述。病人的图纸是有用的,实用,和免费的工具,不需要很多时间,可以促进卫生专业人员的方法,以病人的培训和教育。
    Intermittent claudication is the most common symptom of Peripheral Arterial Disease (PAD) and is associated with decreased quality of life (QoL) due to walking impairment. The level of threat attributed to the disease affects QoL and physical activity. This study explores beliefs and illness drawings, and their relationship with quality of life and physical activity in patients undergoing conservative treatment for PAD. A cross-sectional study was carried out including 119 patients with PAD and Intermittent Claudication, in which patients were asked to freely draw their disease and 33 agreed to participate. The profile of beliefs about PAD is characterized by a low level of threat. Belief in the emotional impact of the disease, representations about the consequences and concern about the disease were associated with worse quality of life; the belief of having a high personal control over the disease was associated with more physical activity. The analysis of the disease drawings revealed three categories: extension of the disease (category 1), location and representations of the disease (category 2), and level of detail and complexity of the drawings (category 3). Greater disease extent was associated with more disease symptoms (IPQ 6) (rs = 0.399, p = .021). It is necessary to address beliefs and representations about the disease in consultations with patients with PAD. Patient drawings are a useful, practical, and free tool that does not require a lot of time and can facilitate the approach of health professionals to patient training and education.
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  • 文章类型: Systematic Review
    关于精神疾病的因果信念的研究-人们对导致特定精神疾病的原因所持的信念,或一般的精神疾病-是分裂在许多理论和学科。尽管对这一主题的研究提供了许多见解和实际应用,理论的多样性,术语,和关键词使新读者获得全面理解变得具有挑战性。我们试图通过对因果信念的研究进行系统的范围审查来解决这个问题。这篇评论包括任何一年的英语文章,这些文章在标题或摘要中提到了精神疾病的因果信念。我们分两个阶段确定了文章。在第一阶段,我们使用了一组狭窄的搜索词,专门指因果信念(确定了1227条记录,包括417)。在第二阶段,我们使用了与因果信念研究相关的一组全面的术语(确定了10,418条记录,包括3838)。我们对文章进行了定性分析,将它们组织成五种理论或类别之一:自我调节的常识模型,解释模型,心理健康素养,生物遗传学因果信念,和其他关于因果信念的研究。我们对这些文献的历史进行了全面的总结,典型的研究问题和研究设计,调查结果,和实际应用。这些理论对因果信念的理论取向不同,研究方法,调查结果,和应用。然而,他们广泛地认为因果信念是多方面的,文化决定,并与其他心理社会变量有关,例如精神疾病的污名和寻求帮助。最后,我们为研究人员提出建议,临床医生,公共卫生信息,以及患有精神疾病的人。
    Research on causal beliefs about mental illness-the beliefs people hold about what causes a particular mental illness, or mental illnesses in general-is split across a number of theories and disciplines. Although research on this subject has provided a number of insights and practical applications, the diversity of theories, terminology, and keywords makes it challenging for a new reader to gain a comprehensive understanding. We sought to address this by conducting a systematic scoping review of research on causal beliefs. This review included English-language articles from any year that mentioned causal beliefs for mental illness in their title or abstract. We identified articles in two stages. In the first stage, we used a narrow set of search terms referring specifically to causal beliefs (1227 records identified, 417 included). In the second stage, we used a comprehensive set of terms relevant to research on causal beliefs (10,418 records identified, 3838 included). We analyzed articles qualitatively, organizing them into one of five theories or categories: the common-sense model of self-regulation, explanatory models, mental health literacy, biogenetic causal beliefs, and other research on causal beliefs. We provide a comprehensive summary of these literatures in terms of their history, typical research questions and study design, findings, and practical applications. These theories differ in their theoretical orientation towards causal beliefs, research methods, findings, and applications. However, they broadly share a view of causal beliefs as multifaceted, culturally determined, and relevant for additional psychosocial variables such as mental illness stigma and help-seeking. We conclude by making recommendations for researchers, clinicians, public health messaging, and for individuals with mental illness.
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  • 文章类型: Journal Article
    早期反应被认为是治疗结果的重要预测指标;然而,关于其在心身康复中的相关性知之甚少。本文旨在描述心身康复中早期反应的关联,以及早期反应与康复前因素如疾病和治疗信念的关联。
    应用具有三个测量点的纵向研究。治疗两周后,使用改善百分比方法定义早期反应。使用多元回归分析了其与治疗结果以及与疾病和治疗信念的关联。
    共有264名参与者参加。早期反应是心身康复结果的重要预测指标,解释了控制初始症状负担后1-30%的递增方差。疾病和治疗信念预测早期反应的6-20%差异。重要的疾病信念指的是感知的症状,疾病的后果和可理解性。重要的治疗信念是指对康复结构的期望,过程和关注点。
    早期反应与心身康复的治疗结果相关,发现疾病和治疗信念与早期反应有关。需要进一步研究心身康复中早期反应的预测因素。
    Early response is considered to be an important predictor for therapy outcomes; yet little is known about its relevance in psychosomatic rehabilitation. This paper aims to describe the association of early response in psychosomatic rehabilitation, as well as the associations of early response with pre-rehabilitative factors such as illness and treatment beliefs.
    A longitudinal study with three measurement points was applied. Early response was defined using the percent improvement method after two weeks of treatment. Its association with therapy outcome and with illness and treatment beliefs was analyzed using multiple regression analyses.
    A total of 264 participants took part. Early response was a significant predictor of psychosomatic rehabilitation outcome, explaining an incremental variance of 1-30% after controlling for initial symptom burden. Illness and treatment beliefs predicted 6-20% variance in early response. Important illness beliefs referred to perceived symptoms, consequences and comprehensibility of the illness. Important treatment beliefs referred to expectations about rehabilitation structure, processes and concerns.
    Early response is associated with the therapy outcome of psychosomatic rehabilitation, with illness and treatment beliefs found to be associated with early response. Further research on the predictors of early response in psychosomatic rehabilitation is needed.
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  • 文章类型: Journal Article
    疾病信念在适应中起作用,应对,幸福,愈合,以及患有慢性病的儿童/青少年家庭的康复。对家庭疾病信念的评估可以支持家庭护理干预措施,以解决患病时家庭成员的痛苦。这项研究的目的是翻译,跨文化适应,和心理测量测试葡萄牙版本的冰岛家庭疾病信念问卷。237名经历过慢性健康状况的儿童/青少年父母的样本完成了在线问卷。通过验证性因素分析对原始因素模型进行了检验。结果显示了令人满意的模型拟合指数(χ2/gl=3.004;比较拟合指数[CFI]=0.90;近似均方根误差[RMSEA]=0.092)和内部一致性(Cronbach'sα=0.74)。该仪器表现出良好的心理测量特征的有效性和可靠性,这表明它可能有助于评估患有儿科慢性疾病的家庭的疾病信念。
    Illness beliefs have a role in the adaptation, coping, well-being, healing, and recovery in families of children/adolescents with chronic illness. The assessment of family illness beliefs can support family nursing interventions that address the suffering of family members when illness arises. The purpose of this study was to translate, cross-culturally adapt, and psychometrically test the Portuguese version of the Iceland-Family Illness Beliefs Questionnaire. A sample of 237 parents of children/adolescents who experienced chronic health conditions completed the online questionnaire. The original factor model was tested through confirmatory factorial analysis. The results showed satisfactory model fit indices (χ2/gl = 3.004; comparative fit index [CFI] = 0.90; root mean square error of approximation [RMSEA] = 0.092) and internal consistency (Cronbach\'s α = 0.74). The instrument showed good psychometric characteristics of validity and reliability, suggesting it may be useful in the assessment of illness beliefs in families experiencing a pediatric chronic illness.
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  • 文章类型: Journal Article
    在这项横断面研究中,作者旨在研究疾病感知之间的关系,衡量为症状归因,以及有创伤性脑损伤(TBI)病史的退伍军人的神经行为和神经认知结果。
    该研究包括55名寻求治疗的退伍军人(N=43,具有足够的性能有效性测试),具有远隔TBI病史(轻度TBI占80%)。退伍军人完成了临床采访,自我报告问卷,和神经心理学评估。对神经行为症状量表(NSI)进行了修改,以评估神经行为症状认可和症状归因。综合得分是根据标准化认知测试计算的,以评估客观认知功能的特定方面。包括记忆,执行功能,注意力和工作记忆,和处理速度。
    TBI最常见的症状包括健忘,浓度差,放慢思维,和头痛。症状归因与总体症状认可(NSI总分)(r=0.675)和特定症状域认可(NSI症状域评分)(r=0.506-0.674)之间存在显着正相关,表明TBI的症状归因更大与更大的症状认可相关。此外,线性回归表明,症状归因与客观认知功能显著相关,而症状认可通常没有显示这种关系。具体来说,TBI症状的更大归因与更差的执行功能相关(β=-0.34),注意力和工作记忆(β=-0.43),和处理速度(β=-0.35)。
    这些研究结果表明,那些经常将神经行为症状归因于TBI的退伍军人有更大的长期预后不良风险,包括升高的症状认可和较差的客观认知。尽管需要更多的研究来了解疾病感知如何影响该人群的结果,这些初步结果凸显了早期心理教育对于TBI后预期康复过程的重要性.
    UNASSIGNED: In this cross-sectional study, the authors aimed to examine relationships between illness perception, measured as symptom attribution, and neurobehavioral and neurocognitive outcomes among veterans with a history of traumatic brain injury (TBI).
    UNASSIGNED: This study included 55 treatment-seeking veterans (N=43 with adequate performance validity testing) with a remote history of TBI (80% with mild TBI). Veterans completed a clinical interview, self-report questionnaires, and a neuropsychological assessment. A modified version of the Neurobehavioral Symptom Inventory (NSI) was administered to assess neurobehavioral symptom endorsement and symptom attribution. Composite scores were calculated from standardized cognitive tests to assess specific aspects of objective cognitive functioning, including memory, executive functioning, attention and working memory, and processing speed.
    UNASSIGNED: The symptoms most frequently attributed to TBI included forgetfulness, poor concentration, slowed thinking, and headaches. There was a significant positive association between symptom attribution and overall symptom endorsement (NSI total score) (r=0.675) and endorsement of specific symptom domains (NSI symptom domain scores) (r=0.506-0.674), indicating that greater attribution of symptoms to TBI was associated with greater symptom endorsement. Furthermore, linear regressions showed that symptom attribution was significantly associated with objective cognitive functioning, whereas symptom endorsement generally did not show this relationship. Specifically, greater attribution of symptoms to TBI was associated with worse executive functioning (β=-0.34), attention and working memory (β=-0.43), and processing speed (β=-0.35).
    UNASSIGNED: These findings suggest that veterans who routinely attribute neurobehavioral symptoms to their TBI are at greater risk of experiencing poor long-term outcomes, including elevated symptom endorsement and worse objective cognition. Although more research is needed to understand how illness perception influences outcomes in this population, these preliminary results highlight the importance of early psychoeducation regarding the anticipated course of recovery following TBI.
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  • 文章类型: Journal Article
    人们认为什么症状构成“抑郁症”?在心理健康素养框架中,了解更多的抑郁症的9个核心症状(根据正式的精神病学诊断标准)被认为有助于人们识别和寻求抑郁症的帮助。然而,自我调节的常识模型表明,关于什么症状构成疾病的更广泛的信念可能是适应不良的,因此,将更多的症状视为一种疾病的特征,预示着更大的功能损害。
    我们收集了N=281名美国青少年抑郁症状升高的数据,通过社交媒体招募。对症状信念进行描述性评估,并进行潜在特征分析,以测试与其他变量的关联。
    青少年对什么症状构成抑郁症的信念差异很大,只有49%的人认可所有DSM-5抑郁症状都是该疾病的特征。确定更多症状属于抑郁症的青少年有更严重的抑郁症状(p=0.004),报告了更多的绝望(p=.021),并且对抑郁症的持久性更加悲观(p=.007);他们也更有可能将药物评价为潜在有用(p=.001)。
    这些发现同时支持和挑战常识模型和心理健康素养框架的要素。未来关于心理健康素养的研究可能会研究为什么对抑郁症有更准确的精神病学理解的青少年会经历更差的临床结果。同样,未来对常识模型的研究应该探索更广泛的抑郁症状信念是否可能是适应性的,也可能是适应不良的。
    UNASSIGNED: What symptoms do people think constitute \"depression\"? In a mental health literacy framework, knowing more of depression\'s nine core symptoms (per formal psychiatric diagnostic criteria) is thought to help people identify and seek help for depression. However, the common-sense model of self-regulation suggests that more expansive beliefs about what symptoms constitute an illness may be maladaptive, whereby viewing more symptoms as characterizing a disorder predicts greater functional impairment.
    UNASSIGNED: We collected data from N = 281 U.S. adolescents experiencing elevated depression symptoms, recruited via social media. Symptom beliefs were assessed descriptively and with a latent profile analysis to test associations with other variables.
    UNASSIGNED: Adolescents\' beliefs about what symptoms constitute depression varied widely, and only 49% endorsed all DSM-5 depression symptoms as characterizing the disorder. Adolescents who identified more symptoms as belonging to depression had more severe depression symptoms (p = .004), reported more hopelessness (p = .021), and were more pessimistic about the permanence of depression (p = .007); they were also more likely to rate medication as potentially helpful (p = .001).
    UNASSIGNED: These findings simultaneously support and challenge elements of both the common-sense model and the mental health literacy framework. Future research on mental health literacy may examine why adolescents with more psychiatrically-accurate understandings of depression experience worse clinical outcomes. Likewise, future research on the common sense model should explore whether more expansive depression symptom beliefs may be adaptive as well as maladaptive.
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  • 文章类型: Journal Article
    背景:慢性肾脏病(CKD)是一种常见的,渐进条件。生活方式的改变和降压药物可以减缓终末期肾病的进展,需要肾脏替代疗法.然而,对这些建议的坚持率通常很低。
    目的:CareknowDo的目的是评估与面向患者的电子健康记录集成的数字自我管理支持和依从性计划的可行性。患者视图(PV)。
    方法:双臂,平行,在英国的2个国家卫生服务(NHS)中心进行了个体层面的实用性可行性先导随机对照试验.共有61例CKD患者以1:1随机分为2组,并提供一种新的,量身定制的数字和电话支持计划(CareknowDo:31/61,51%)与PV或标准护理(仅PV:30/61,49%)集成。定量措施包括临床和社会心理措施。主要结果是基于可行性:招募率,辍学,和协会的探索。
    结果:在当地肾脏诊所筛查的1392名患者中,269名(19.32%)符合基本纳入标准;符合资格标准的前22.7%(61/269)被招募参加研究。在69名患者中,23名(38%)患者完成了最后6个月的网络随访调查。探讨了减员的原因。对治疗控制CKD能力的更高信念与基线血压较低相关(r=0.52;P=0.005),基线时对CKD的认知较高与随访时血压较低相关(r=0.66;P<.001)。基线时对药物的信念与基线时的血压有关,但与随访时无关。对于对药物的关注(r=0.58;P=.001)和对药物的必要性(r=0.42;P=.03)都是如此。
    结论:在2个NHS站点试行了一项量身定制的数字和基于护士电话的计划,以增强对CKD患者的支持,该计划被认为是可行和可接受的。然而,为了最大限度地提高干预措施(以及未来试验)的有效性,应该考虑最有可能受益的目标受众,以及如何帮助他们尽可能快速,轻松地访问该程序。
    背景:NHS健康研究机构,IRASID184206;https://www.hra.Nhs.英国/规划和改进-研究/应用-总结/研究-总结/careknowdo-pilot-version-1/。
    BACKGROUND: Chronic kidney disease (CKD) is a common, progressive condition. Lifestyle changes and antihypertensive medication can slow the progression to end-stage kidney disease, which requires renal replacement therapy. However, adherence to these recommendations is often low.
    OBJECTIVE: The aim of CareKnowDo was to assess the feasibility of rolling out a digital self-management support and adherence program integrated with a patient-facing electronic health record, Patient View (PV).
    METHODS: A 2-arm, parallel, individual-level pragmatic feasibility pilot randomized controlled trial was conducted at 2 National Health Service (NHS) sites in the United Kingdom. A total of 61 patients with CKD were randomized 1:1 into 2 groups and provided with either a new, tailored digital and telephone support program (CareKnowDo: 31/61, 51%) integrated with PV or standard care (PV alone: 30/61, 49%). Quantitative measures included clinical and psychosocial measures. The primary outcomes were feasibility based: recruitment rate, dropout, and the exploration of associations.
    RESULTS: Of the 1392 patients screened in local kidney clinics, 269 (19.32%) met the basic inclusion criteria; the first 22.7% (61/269) who met the eligibility criteria were recruited to participate in the study. Of the 69 patients, 23 (38%) patients completed the final 6-month follow-up web-based survey. Reasons for the attrition were explored. A higher belief in the ability of the treatment to control CKD was associated with lower blood pressure at baseline (r=0.52; P=.005), and a higher perceived understanding of CKD at baseline was associated with lower blood pressure at follow-up (r=0.66; P<.001). Beliefs about medicines at baseline were associated with blood pressure at baseline but not at follow-up. This was true for both concerns about medicines (r=0.58; P=.001) and perceived necessity of medicines (r=0.42; P=.03).
    CONCLUSIONS: A tailored digital and nurse call-based program to enhance support for patients with CKD was piloted in 2 NHS sites and found to be feasible and acceptable. However, to maximize the effectiveness of the intervention (and of future trials), consideration should be given to the target audience most likely to benefit, as well as how to help them access the program as quickly and easily as possible.
    BACKGROUND: NHS Health Research Authority, IRAS ID 184206; https://www.hra.nhs.uk/planning-and-improving -research/application-summaries/research-summaries/careknowdo-pilot-version-1/.
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