RESUMO
PURPOSE: The purpose of this research was to evaluate the impact of a nurse-directed approach to patient education, which focused on lifestyle modification, daily weight management, diet, and medication compliance to improve the quality of life (QOL) and functional capacity in people with heart failure. DATA SOURCES: This was a prospective quasiexperimental multicenter research study of 23 patients comparing a nurse-directed care (NC) group (n = 13), which received comprehensive disease management education and weekly telephone follow-up, and the routine care (RC) group (n = 10) that received protocol-driven medical management. The study length was 12 months. CONCLUSIONS: Analysis of covariance (ANCOVA) was used to test for equality of variance-covariance matrices in the study population over time. ANCOVA measured baseline and two data intervals for a total of 9 months between the control and experimental (NC and RC) groups. There was statistically significant improvement in the NC group for the domains of total QOL: F = 3.569, p = 0.000; health and function: F = 3.995, p = 0.003; social and economic: F = 14.109, p = 0.000; psychological and spiritual: F = 13.212, p = 0.000; and family: F = 2.384, p = 0.048. Functional capacity was not significantly impacted by the study team interventions (F = 0.228, p = 0.949). IMPLICATIONS FOR PRACTICE: Results indicate that nurse-directed patient education was effective in improving QOL. A nurse-directed treatment strategy significantly improves patients' role in symptom control and disease self-management.
Assuntos
Atividades Cotidianas , Insuficiência Cardíaca/prevenção & controle , Enfermeiros Clínicos/organização & administração , Educação de Pacientes como Assunto/organização & administração , Qualidade de Vida , Atividades Cotidianas/psicologia , Assistência ao Convalescente/organização & administração , Análise de Variância , Dieta Hipossódica , Gerenciamento Clínico , Feminino , Insuficiência Cardíaca/classificação , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/psicologia , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Pesquisa em Avaliação de Enfermagem , Cooperação do Paciente/psicologia , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Qualidade de Vida/psicologia , Autocuidado , Índice de Gravidade de Doença , TelefoneRESUMO
The Neurovascular Education and Training in Stroke Management and Acute Reperfusion Therapy (NET SMART) program for advanced practice nursing (APN) offers a first-of-its-kind, academic, postgraduate, fellowship program for APNs that is modeled after physician academic fellowship programs but supported by a flexible Internet-based platform. This article details the rationale, methods, and preliminary results of the NET SMART APN experience, which serves as a unique template for the development of academic postgraduate nursing fellowship programs across a variety of specialty practices.