Publication: Kronik kalp yetersizliğinde palyatif bakım eğitiminin semptom yönetimi, yeniden yatışlar ve yaşam kalitesi üzerine etkisi
Abstract
Amaç: Kronik kalp yetersizliği hastalarına verilen palyatif bakım eğitiminin hastaların semptom yönetimi, yeniden yatışlar ve yaşam kalitesi üzerine etkisini belirlemek amacıyla randomize kontrollü bir çalışma olarak planlandı.Gereç ve Yöntem: Çalışmaya Ocak-Aralık 2017 tarihlerinde, Kocaeli ilinde bulanan bir araştırma ve uygulama hastanesinde, NYHA göre sınıf III-IV kalp yetersizliğine sahip 42 deney ve 42 kontrol grubu hastası alındı. Kontrol grubundaki hastalar rutin tedavisini alırken deney grubu hastalarına rutin tedavisiyle birlikte palyatif bakım eğitimi verildi. Hastalar taburcu olmadan ve taburculuk sonrası birinci, üçüncü ve altıncı aylarda değerlendirildi. Veri toplamada hasta bilgi formu anketi, Edmontom Semptom Tanılama Ölçeği, EQ-5D yaşam kalitesi ölçeği ve LVD-36-Sol Ventrikül Disfonksiyon ölçeği kullanıldı. Bulgular: Çalışmada gruplar arasında hastaların sosyodemografik ve tıbbi özellikleri açısından fark saptanmadı. Edmonton semptom tanılama ölçeğine göre taburculuk sonrası birinci ay deney grubunun yorgunluk (p=,044), bulantı (p=,016), iştahsızlık (p=,030), ayaklarda ödem (p=,021) ve toplam semptom yükü (p=,027) ve üçüncü aydaki yorgunluk (p=,042), bulantı (p=,014) ve ayaklarda ödem (p=,042) puanı kontrol grubuna göre daha iyi olduğu bulundu. EQ-5D yaşam kalitesi ölçeğine göre deney grubunun birinci ay anksiyete/ depresyon puanı kontrol grubuna göre daha iyi olduğu saptandı (p=,006). LVD-36 ölçeğine göre gruplar arasında fark belirlenmedi. Deney grubundaki hastaların birinci (p=,001), üçüncü (p=,001) ve altıncı (p= ,001) ay hastaneye yatış oranı kontrol grubundan düşük olduğu bulundu. Sonuç: Palyatif bakım alan hastaların birinci ay semptom yükü daha iyi ve birinci, üçüncü ve altıncı ay hastaneye yeniden yatışlarının az olduğu bulundu.
Objective: This study was planned as a randomized controlled trial to determine the effect of palliative care education on symptom management, readmission, and quality of life among patients with chronic heart failure.Material and Method: The study was enrolled 42 intervention and 42 control group patients who have class III-IV heart failure according to NYHA to a research and practice hospital in Kocaeli province between Jaunuary-December 2017. While Patients in the control group received usual treatment, intervention group were given both usual treatment and palliative care education. Patients were evaluated at baseline and at first, third and sixth months after discharge. Data were collected with Patient Informatin Form, Edmonton Symptom Assessment Scale, EQ-5D quality of life scale and LVD-36-Left Ventricular Dysfunction scale. Results: The study was no difference between the groups in terms of sociodemographic and medical characteristics of the patients. According to the Edmonton Symptom Assessment Scale, fatigue (p=.044), nausea (p=.016), appetite (p=.030), oedema of feet (p=.021) and total symptom burden (p=.027) at first month after discharge and at the third month, fatigue (p=.042), nausea (p=.014) and oedema of feet (p=.042) to intervention group were found to be better than the control group. According to the EQ-5D quality of life scale, anxiety / depression score of the intervention group was better than the control group at the first month. (p=.006). The LVD-36 scale wasn't difference between the groups. The intervention group were found to have lower readmission rate the first (p=.001), third (p=.001) and sixth month (p=.001) than control group. Conclusion: Patients receiving palliative care had better symptom burden in the first month and was less readmission in the first, third and sixth month.
Objective: This study was planned as a randomized controlled trial to determine the effect of palliative care education on symptom management, readmission, and quality of life among patients with chronic heart failure.Material and Method: The study was enrolled 42 intervention and 42 control group patients who have class III-IV heart failure according to NYHA to a research and practice hospital in Kocaeli province between Jaunuary-December 2017. While Patients in the control group received usual treatment, intervention group were given both usual treatment and palliative care education. Patients were evaluated at baseline and at first, third and sixth months after discharge. Data were collected with Patient Informatin Form, Edmonton Symptom Assessment Scale, EQ-5D quality of life scale and LVD-36-Left Ventricular Dysfunction scale. Results: The study was no difference between the groups in terms of sociodemographic and medical characteristics of the patients. According to the Edmonton Symptom Assessment Scale, fatigue (p=.044), nausea (p=.016), appetite (p=.030), oedema of feet (p=.021) and total symptom burden (p=.027) at first month after discharge and at the third month, fatigue (p=.042), nausea (p=.014) and oedema of feet (p=.042) to intervention group were found to be better than the control group. According to the EQ-5D quality of life scale, anxiety / depression score of the intervention group was better than the control group at the first month. (p=.006). The LVD-36 scale wasn't difference between the groups. The intervention group were found to have lower readmission rate the first (p=.001), third (p=.001) and sixth month (p=.001) than control group. Conclusion: Patients receiving palliative care had better symptom burden in the first month and was less readmission in the first, third and sixth month.