脑卒中延续性照护效果评价指标研究进展
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摘要
从过程评价指标和结果评价指标两个方面对脑卒中延续性照护效果评价指标的相关研究进行综述。过程评价指标包括信息的延续性、管理的延续性和关系的延续性。结果评价指标包括患者的临床结局、医疗卫生资源利用率和患者满意度。提出了研究的不足和未来的研究方向,以期为今后构建统一、规范的脑卒中延续性照护效果评价指标提供参考。
This paper reviewed the continuity of care outcome evaluation indicators for stroke from process evaluation indicators and outcome evaluation indicators. Process evaluation indicators included information continuity, management continuity and relationship continuity. Outcome evaluation indicators included clinical outcome of patient, utilization rates of medical resources and patient satisfaction. In addition, this paper put forward weakness in current research and direction in future research, so as to provide a reference for future establishment of uniform and standardized outcome evaluation indicators for stroke.
This paper reviewed the continuity of care outcome evaluation indicators for stroke from process evaluation indicators and outcome evaluation indicators. Process evaluation indicators included information continuity, management continuity and relationship continuity. Outcome evaluation indicators included clinical outcome of patient, utilization rates of medical resources and patient satisfaction. In addition, this paper put forward weakness in current research and direction in future research, so as to provide a reference for future establishment of uniform and standardized outcome evaluation indicators for stroke.
引文
[1]Mozaffarian D,Benjamin EJ,Go AS,et al.Heart disease and stroke statistics-2016 update:a report from the American Heart Association.Circulation,2016,133(4):e38-e360.
[2]World Health Organization.Global burden of stroke.[2018-09-14].http://www.who.int/cardiovascular_diseases/en/cvd_atlas_15_burden_stroke.pdf?ua=1.shtml.
[3]Yang G,Wang Y,Zeng Y,et al.Rapid health transition in China,1990-2010:findings from the Global Burden of Disease Study 2010.Lancet,2013,381(9882):1987-2015.
[4]国家卫生和计划生育委员会脑卒中筛查与防治工程委员会.卒中筛查与防治技术规范.中华神经科杂志,2014,47(3):199-203.Stroke Screening and Prevention Project Committee,National Health and Family Planning Commission,P.R.China.Standard for screening and prevention of stroke.Chinese Journal of Neurology,2014,47(3):199-203.
[5]王娟,黄卡,林田,等.基于家庭医生责任制的脑卒中病人延续性照护模式的探讨.护理研究,2016,30(31):3939-3941.Wang J,Huang K,Lin T,et al.Probe into continuity of care model for stroke patients based on family doctor responsibility system.Chinese Nursing Research,2016,30(31):3939-3941.
[6]Condon C,Lycan S,Duncan P,et al.Reducing readmissions after stroke with a structured nurse practitioner/registered nurse transitional stroke program.Stroke,2016,47(6):1599-1604.
[7]P u h r MI,T hompson HJ.T he use of transitional care models in patients with stroke.JNeurosci Nurs,2015,47(4):223-234.
[8]Ontario HQ.Continuity of care to optimize chronic disease management in the community setting:an evidence-based analysis.Ont Health Technol Assess Ser,2013,13(6):1-41.
[9]Reid R,Haggerty J,Mckendry R.Defusing the confusion:concepts and measures of continuity of health care[2018-08-15].https://www.cfhifcass.ca/Migrated/PDF/ResearchReports/Commissioned Research/cr_contcare_e.pdf.
[10]van Walraven C,Oake N,Jennings A,et al.The association between continuity of care and outcomes:a systematic and critical review.J Eval Clin Pract,2010,16(5):947-956.
[11]汪苗,李远珍,管慧.慢病患者延续护理效果评价指标体系构建.中国护理管理,2017,17(10):1384-1388.Wang M,Li YZ,Guan H.Development of the outcome evaluation indicator system for transitional care of chronic illness.Chinese Nursing Management,2017,17(10):1384-1388.
[12]王云璐,林蓓蕾,张振香.脑卒中连续护理效果评价指标及工具的应用现状.中国实用护理杂志,2013,29(20):34-37.Wang YL,Lin BL,Zhang ZX.Current situation of outcome evaluation indicators and tools for continuous care of stroke.Chinese Journal of Practical Nursing,2013,29(20):34-37.
[13]陈璐,奚兴,Janet Sit.三级医院延续性护理服务质量评价指标体系的构建.护理学杂志,2015,30(10):94-97.Chen L,Xi X,Janet S.Development of an evaluation system for transitional care by tertiary hospitals.Journal of Nursing Science,2015,30(10):94-97.
[14]Hill KM,Twiddy M,Hewison J,et al.Measuring patient-perceived continuity of care for patients with long-term conditions in primary care.BMC Fam Pract,2014(15):191.
[15]van Walraven C,Taljaard M,Bell CM,et al.A prospective cohort study found that provider and information continuity was low after patient discharge from hospital.J Clin Epidemiol,2010,63(9):1000-1010.
[16]Benito L,Espinosa J,Binefa G,et al.Population-based cancer screening:measurement of coordination and continuity of care.Cancer Nurs,2018,41(4):E1-E11.
[17]Jeffs L,Law MP,Straus S,et al.Defining quality outcomes for complex-care patients transitioning across the continuum using a structured panel process.BMJ Qual Saf,2013,22(12):1014-1024.
[18]卫生部办公厅.关于印发《基于健康档案的区域卫生信息平台建设指南(试行)》的通知.2009-05.Notification of the General Office of the Ministry of Health on the issue of printing and distributing technical solutions for the construction of a regional health information platform based on health records(pilot).2009-05.
[19]郜慧青.医院-社区-家庭对接的延续性护理在脑卒中康复期患者中的应用.中国药物与临床,2016,16(10):1537-1540.Gao HQ.Application of hospital-communityfamily based transitional care in stroke patients during rehabilitation period.Chinese Remedies&Clinics,2016,16(10):1537-1540.
[20]Haggerty JL,Reid RJ,Freeman GK,et al.Continuity of care:a multidisciplinary review.BMJ,2003,327(7425):1219-1221.
[21]Kerse N,Buetow S,Mainous AR,et al.Physician-patient relationship and medication compliance:a primary care investigation.Ann Fam Med,2004,2(5):455-461.
[22]Dreiher J,Comaneshter DS,Rosenbluth Y,et al.The association between continuity of care in the community and health outcomes:a population-based study.Isr J Health Policy Res,2012,1(1):21.
[23]Altfeld SJ,Shier GE,Rooney M,et al.Effects of an enhanced discharge planning intervention for hospitalized older adults:a randomized trial.Gerontologist,2013,53(3):430-440.
[24]孙晓,杨开阳,施雁.国外慢病延续性照护现状及启示.现代临床护理,2018,17(4):72-76.Sun X,Yang KY,Shi Y.A survey of continuance care for patients with chronic diseases abroad.Modern Clinical Nursing,2018,17(4):72-76.
[25]World Health Organization.World health statistics 2016:monitoring health for the SDGs.[2018-09-14].http://www.who.int/gho/publications/world_health_statistics/2016/en/.shtml.
[26]孙爱国,刘婷婷,刘晓丹,等.脑卒中患者连续性护理的应用及效果评价.中国医院管理,2014,34(9):71-73.Sun AG,Liu TT,Liu XD,et al.Application and evaluation of the continuous nursing for stroke patients.Chinese Hospital Management,2014,34(9):71-73.
[27]于文琦,魏琳,张广清.脑卒中护理敏感性质量指标评价体系的构建.重庆医学,2017,46(12):1720-1723.Yu WQ,Wei L,Zhang GQ.Construction of nursing sensitive quality indicators system for stroke.Chongqing Medicine,2017,46(12):1720-1723.
[28]Appel LJ,Brands MW,Daniels SR,et al.Dietar y approaches to prevent and t reat hypertension:a scientific statement from the American Heart Association.Hypertension,2006,47(2):296-308.
[29]李杨.脑卒中患者延续性护理干预的效果评价.长春:吉林大学,2016.Li Y.Evaluation of a transitional care intervention for stroke patients.Changchun:Jilin University,2016.
[30]纪翠红,于红静,郭慧玲,等.基于患者需求和德尔菲法构建三甲医院延续性护理模式.护理学杂志,2018,33(7):57-60.Ji CH,Yu HJ,Guo HL,et al.Construction of transitional care model for grade three hospitals based on patient needs and Delphi methods.Journal of Nursing Science,2018,33(7):57-60.
[31]Mayo NE,Nadeau L,Ahmed S,et al.Bridging the gap:the effectiveness of teaming a stroke coordinator with patient's personal physician on the outcome of stroke.Age Ageing,2008,37(1):32-38.
[32]Askim T,Morkved S,Indredavik B.Does an extended stroke unit service with early supported discharge have any effect on balance or walking speed?.J Rehabil Med,2006,38(6):368-374.
[33]Grube MM,Dohle C,Djouchadar D,et al.Evidence-based quality indicators for stroke rehabilitation.Stroke,2012,43(1):142-146.
[34]李小英,曹文静,邓暑芳,等.延续性护理干预在脑卒中患者中的应用.中国护理管理,2014,14(7):703-706.Li XY,Cao WJ,Deng SF,et al.Effects of continuing care on stroke patients.Chinese Nursing Management,2014,14(7):703-706.
[35]Liu H,Lou V.Functional recovery of older stroke patients discharged from hospital to home:The effects of cognitive status and different levels of therapy intensity.J Clin Nurs,2018.
[36]李桂,朱小平,陈晓莉.我国延续性护理研究热点的共词聚类分析.中国实用护理杂志,2018,34(23):1824-1829.Li G,Zhu XP,Chen XL.A co-word cluster analysis of transitional care.Chinese Journal of Practical Nursing,2018,34(23):1824-1829.
[37]刘敏杰,张兰凤,叶赟,等.结构-过程-结果模式在护理质量评价中的应用进展.中华护理杂志,2013,48(4):371-374.Liu MJ,Zhang LF,Ye Y,et al.Application of structure-process-outcome model in nursing quality evaluation:a literature review.Chinese Journal of Nursing,2013,48(4):371-374.
[38]王素芳,常晋霞,柏雪.住院脑卒中病人焦虑与抑郁现状及影响因素分析.护理研究,2018,32(13):2148-2150.Wang SF,Chang JX,Bai X.Status of anxiety and depression in hospitalized patients with cerebral apoplexy and its influencing factors.Chinese Nursing Research,2018,32(13):2148-2150.
[39]Terman SW,Reeves MJ,Skolarus LE,et al.Association between early outpatient visits and readmissions after ischemic stroke.Circ Cardiovasc Qual Outcomes,2018,11(4):e4024.
[40]国务院办公厅.关于印发《中国防治慢性病中长期规划(2017-2025年)》的通知.(2017-02-14).Notification of the State Council on the issue of printing and distributing"Mid-term and longterm plan for the prevention and treatment for chronic disease in China(2017-2025)".(2017-02-14).
[2]World Health Organization.Global burden of stroke.[2018-09-14].http://www.who.int/cardiovascular_diseases/en/cvd_atlas_15_burden_stroke.pdf?ua=1.shtml.
[3]Yang G,Wang Y,Zeng Y,et al.Rapid health transition in China,1990-2010:findings from the Global Burden of Disease Study 2010.Lancet,2013,381(9882):1987-2015.
[4]国家卫生和计划生育委员会脑卒中筛查与防治工程委员会.卒中筛查与防治技术规范.中华神经科杂志,2014,47(3):199-203.Stroke Screening and Prevention Project Committee,National Health and Family Planning Commission,P.R.China.Standard for screening and prevention of stroke.Chinese Journal of Neurology,2014,47(3):199-203.
[5]王娟,黄卡,林田,等.基于家庭医生责任制的脑卒中病人延续性照护模式的探讨.护理研究,2016,30(31):3939-3941.Wang J,Huang K,Lin T,et al.Probe into continuity of care model for stroke patients based on family doctor responsibility system.Chinese Nursing Research,2016,30(31):3939-3941.
[6]Condon C,Lycan S,Duncan P,et al.Reducing readmissions after stroke with a structured nurse practitioner/registered nurse transitional stroke program.Stroke,2016,47(6):1599-1604.
[7]P u h r MI,T hompson HJ.T he use of transitional care models in patients with stroke.JNeurosci Nurs,2015,47(4):223-234.
[8]Ontario HQ.Continuity of care to optimize chronic disease management in the community setting:an evidence-based analysis.Ont Health Technol Assess Ser,2013,13(6):1-41.
[9]Reid R,Haggerty J,Mckendry R.Defusing the confusion:concepts and measures of continuity of health care[2018-08-15].https://www.cfhifcass.ca/Migrated/PDF/ResearchReports/Commissioned Research/cr_contcare_e.pdf.
[10]van Walraven C,Oake N,Jennings A,et al.The association between continuity of care and outcomes:a systematic and critical review.J Eval Clin Pract,2010,16(5):947-956.
[11]汪苗,李远珍,管慧.慢病患者延续护理效果评价指标体系构建.中国护理管理,2017,17(10):1384-1388.Wang M,Li YZ,Guan H.Development of the outcome evaluation indicator system for transitional care of chronic illness.Chinese Nursing Management,2017,17(10):1384-1388.
[12]王云璐,林蓓蕾,张振香.脑卒中连续护理效果评价指标及工具的应用现状.中国实用护理杂志,2013,29(20):34-37.Wang YL,Lin BL,Zhang ZX.Current situation of outcome evaluation indicators and tools for continuous care of stroke.Chinese Journal of Practical Nursing,2013,29(20):34-37.
[13]陈璐,奚兴,Janet Sit.三级医院延续性护理服务质量评价指标体系的构建.护理学杂志,2015,30(10):94-97.Chen L,Xi X,Janet S.Development of an evaluation system for transitional care by tertiary hospitals.Journal of Nursing Science,2015,30(10):94-97.
[14]Hill KM,Twiddy M,Hewison J,et al.Measuring patient-perceived continuity of care for patients with long-term conditions in primary care.BMC Fam Pract,2014(15):191.
[15]van Walraven C,Taljaard M,Bell CM,et al.A prospective cohort study found that provider and information continuity was low after patient discharge from hospital.J Clin Epidemiol,2010,63(9):1000-1010.
[16]Benito L,Espinosa J,Binefa G,et al.Population-based cancer screening:measurement of coordination and continuity of care.Cancer Nurs,2018,41(4):E1-E11.
[17]Jeffs L,Law MP,Straus S,et al.Defining quality outcomes for complex-care patients transitioning across the continuum using a structured panel process.BMJ Qual Saf,2013,22(12):1014-1024.
[18]卫生部办公厅.关于印发《基于健康档案的区域卫生信息平台建设指南(试行)》的通知.2009-05.Notification of the General Office of the Ministry of Health on the issue of printing and distributing technical solutions for the construction of a regional health information platform based on health records(pilot).2009-05.
[19]郜慧青.医院-社区-家庭对接的延续性护理在脑卒中康复期患者中的应用.中国药物与临床,2016,16(10):1537-1540.Gao HQ.Application of hospital-communityfamily based transitional care in stroke patients during rehabilitation period.Chinese Remedies&Clinics,2016,16(10):1537-1540.
[20]Haggerty JL,Reid RJ,Freeman GK,et al.Continuity of care:a multidisciplinary review.BMJ,2003,327(7425):1219-1221.
[21]Kerse N,Buetow S,Mainous AR,et al.Physician-patient relationship and medication compliance:a primary care investigation.Ann Fam Med,2004,2(5):455-461.
[22]Dreiher J,Comaneshter DS,Rosenbluth Y,et al.The association between continuity of care in the community and health outcomes:a population-based study.Isr J Health Policy Res,2012,1(1):21.
[23]Altfeld SJ,Shier GE,Rooney M,et al.Effects of an enhanced discharge planning intervention for hospitalized older adults:a randomized trial.Gerontologist,2013,53(3):430-440.
[24]孙晓,杨开阳,施雁.国外慢病延续性照护现状及启示.现代临床护理,2018,17(4):72-76.Sun X,Yang KY,Shi Y.A survey of continuance care for patients with chronic diseases abroad.Modern Clinical Nursing,2018,17(4):72-76.
[25]World Health Organization.World health statistics 2016:monitoring health for the SDGs.[2018-09-14].http://www.who.int/gho/publications/world_health_statistics/2016/en/.shtml.
[26]孙爱国,刘婷婷,刘晓丹,等.脑卒中患者连续性护理的应用及效果评价.中国医院管理,2014,34(9):71-73.Sun AG,Liu TT,Liu XD,et al.Application and evaluation of the continuous nursing for stroke patients.Chinese Hospital Management,2014,34(9):71-73.
[27]于文琦,魏琳,张广清.脑卒中护理敏感性质量指标评价体系的构建.重庆医学,2017,46(12):1720-1723.Yu WQ,Wei L,Zhang GQ.Construction of nursing sensitive quality indicators system for stroke.Chongqing Medicine,2017,46(12):1720-1723.
[28]Appel LJ,Brands MW,Daniels SR,et al.Dietar y approaches to prevent and t reat hypertension:a scientific statement from the American Heart Association.Hypertension,2006,47(2):296-308.
[29]李杨.脑卒中患者延续性护理干预的效果评价.长春:吉林大学,2016.Li Y.Evaluation of a transitional care intervention for stroke patients.Changchun:Jilin University,2016.
[30]纪翠红,于红静,郭慧玲,等.基于患者需求和德尔菲法构建三甲医院延续性护理模式.护理学杂志,2018,33(7):57-60.Ji CH,Yu HJ,Guo HL,et al.Construction of transitional care model for grade three hospitals based on patient needs and Delphi methods.Journal of Nursing Science,2018,33(7):57-60.
[31]Mayo NE,Nadeau L,Ahmed S,et al.Bridging the gap:the effectiveness of teaming a stroke coordinator with patient's personal physician on the outcome of stroke.Age Ageing,2008,37(1):32-38.
[32]Askim T,Morkved S,Indredavik B.Does an extended stroke unit service with early supported discharge have any effect on balance or walking speed?.J Rehabil Med,2006,38(6):368-374.
[33]Grube MM,Dohle C,Djouchadar D,et al.Evidence-based quality indicators for stroke rehabilitation.Stroke,2012,43(1):142-146.
[34]李小英,曹文静,邓暑芳,等.延续性护理干预在脑卒中患者中的应用.中国护理管理,2014,14(7):703-706.Li XY,Cao WJ,Deng SF,et al.Effects of continuing care on stroke patients.Chinese Nursing Management,2014,14(7):703-706.
[35]Liu H,Lou V.Functional recovery of older stroke patients discharged from hospital to home:The effects of cognitive status and different levels of therapy intensity.J Clin Nurs,2018.
[36]李桂,朱小平,陈晓莉.我国延续性护理研究热点的共词聚类分析.中国实用护理杂志,2018,34(23):1824-1829.Li G,Zhu XP,Chen XL.A co-word cluster analysis of transitional care.Chinese Journal of Practical Nursing,2018,34(23):1824-1829.
[37]刘敏杰,张兰凤,叶赟,等.结构-过程-结果模式在护理质量评价中的应用进展.中华护理杂志,2013,48(4):371-374.Liu MJ,Zhang LF,Ye Y,et al.Application of structure-process-outcome model in nursing quality evaluation:a literature review.Chinese Journal of Nursing,2013,48(4):371-374.
[38]王素芳,常晋霞,柏雪.住院脑卒中病人焦虑与抑郁现状及影响因素分析.护理研究,2018,32(13):2148-2150.Wang SF,Chang JX,Bai X.Status of anxiety and depression in hospitalized patients with cerebral apoplexy and its influencing factors.Chinese Nursing Research,2018,32(13):2148-2150.
[39]Terman SW,Reeves MJ,Skolarus LE,et al.Association between early outpatient visits and readmissions after ischemic stroke.Circ Cardiovasc Qual Outcomes,2018,11(4):e4024.
[40]国务院办公厅.关于印发《中国防治慢性病中长期规划(2017-2025年)》的通知.(2017-02-14).Notification of the State Council on the issue of printing and distributing"Mid-term and longterm plan for the prevention and treatment for chronic disease in China(2017-2025)".(2017-02-14).