Effectiveness of a Comprehensive Resource-Building Approach in the Prevention of Readmission for Patients with Heart Failure

Research Project

Project/Area Number	16K20774
Research Category	Grant-in-Aid for Young Scientists (B)
Allocation Type	Multi-year Fund
Research Field	Clinical nursing
Research Institution	Juntendo University
Principal Investigator	KITAMURA YUKIE 順天堂大学, 医療看護学部, 助教 (10773731)
Project Period (FY)	2016-04-01 – 2020-03-31
Project Status	Completed (Fiscal Year 2019)
Budget Amount *help	¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000) Fiscal Year 2018: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000) Fiscal Year 2017: ¥520,000 (Direct Cost: ¥400,000、Indirect Cost: ¥120,000) Fiscal Year 2016: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Keywords	初回心不全 / 症状マネジメント / 外来継続看護 / QOL / 精神健康状態 / セルフケア / 再入院予防 / 自己管理行動 / 継続介入 / 急性増悪予防 / 慢性心不全 / 療養行動変容 / 自己管理支援 / 療養上の困難 / 専門看護師 / 認定看護師 / 心不全 / セルフマネジメント / 資源構築 / 包括的資源構築
Outline of Final Research Achievements	This study aims to elucidate the extent of self-care incorporation in patients with heart failure hospitalized for the first time consequent to continuous intervention by nurses during hospitalization and outpatient care, as well as the influence of the intervention on patients’ qualities of life (QOL) and mental health status. We conducted interviews with the patients regarding difficulties in recuperation that they experienced after discharge until the initial outpatient visit as well as differences in their self-care behaviors after 6 months between the two intervention groups. Furthermore, we conducted a qualitative descriptive analysis of the results obtained from the interview. To determine the differences in QOL and mental health status between patients in the two groups, we used the SF-12 and GHQ-12 and conducted a two-way analysis of variance for parallel comparison of mean values measured at the initial visit and those measured after 6 months.
Academic Significance and Societal Importance of the Research Achievements	本研究の成果として、初回心不全患者の退院後の外来までに抱える療養上の困難を明らかにすることで、看護介入における示唆を得ることが出来た。また2群におけるセルフケア行動の差異では、看護介入群において、自己の生活にセルフケアを組み込むことやストレスをコントロールして自分らしい生き方を大切にする特徴的なカテゴリーが挙げられた。通常診察群において、自立してセルフケア行動を行う反面、不安を抱えながら生活していることが分かり、外来における患者支援の必要性が示唆された。