《艾滋病临床护理实践指南》临床应用效果研究  

A Survey of Evidence Translation:Getting "HIV/AIDS Clinical Nursing Practice Guideline” into Clinical Practice

作　　者：朱政[1] 胡雁[1] 鲍美娟[2] 张林[2] 查丽俊[2] 侯雪红[2] 卢洪洲[2] 

机构地区：[1]复旦大学护理学院,上海200032 [2]上海市公共卫生临床中心护理部,上海201058

出　　处：《中国循证医学杂志》2016年第5期505-509,共5页Chinese Journal of Evidence-based Medicine

基　　金：上海市第三轮公共卫生体系建设三年行动计划(2011年~2013年)资助项目(编号:GWⅢ-13-11)

摘　　要：目的将《艾滋病临床护理实践指南》中症状管理相关证据应用到护理实践中,并评价其在提高艾滋病住院患者生活质量中的效果。方法以渥太华证据转化模式为概念框架,通过评估现状、构建循证策略和循证实践模式、循证决策应用、评价应用效果和反思4个阶段,于2013年9月至2015年2月从指南中选择相关证据整合到艾滋病病房的护理实践中,在实施干预2个月后通过MOS-HIV量表评价148名艾滋病住院患者的生活质量评分的改变。结果患者的MOS-HIV生活质量量表各维度在干预方法和干预时间上有一定的交互作用;干预组比对照组每月在MOS-HIV总分上多上升2.72分(P<0.05)。结论应用《艾滋病临床护理实践指南》可规范护士的护理行为,提高临床护理质量和患者生活质量。Objective To translate evidence of＂HIV/AIDS Clinical Nursing Practice Guideline＂ into clinical practice, in order to reduce the incidence and severity of symptoms of AIDS and to improve the quality of life of patients. Methods We integrated the best evidence into the HIV/AIDS inpatient unit of a tertiary hospital for infectious disease in Shanghai, China between September 2013 and February 2015. Based on the ＂Ottawa Model of Research Use＂, this study was divided into four stages： evaluating the status quo, building the evidence-based strategy, applying evidence- based decision-making, and evaluating results and reflecting. 148 patients were either assigned to an intervention group with HIV/AIDS-related symptom management protocol （n=74）, or to a usual care group （n=74） for the duration of their antiretroviral therapy. Then Medical Outcomes Questionnaire （MOS-HIV） were applied to evaluate the life quality after intervention. Results Mixed-effects regression indicated significant difference between groups across time in total MOS-HIV score. The intervention group increased more than the control group 2.72 points in total MOS-HIV scores per month （P〈0.05）. Conclusion The evidence-translation and evidence-based decision-making of＂HIV/AIDS Clinical Nursing Practice Guideline＂ can regulate nurse behavior, raise the quality of clinical care and improve the patients＇ quality of life.

关 键 词：循证实践 临床实践指南 证据转化 HIV/AIDS 艾滋病 

分 类 号：R473.5[医药卫生—护理学]