摘要
Objective:This study aims to evaluate the effects of a symptom management intervention(SMI)based on symptom management group sessions combined with a mobile health(mHealth)application(app)on the knowledge of symptom management,the certainty of symptom self-management,symptom severity,symptom distress,medication adherence,social support,and quality of life among persons living with HIV(PLWH)in China.Methods:A parallel randomized controlled trial with 61 PLWH was conducted in Shanghai,China.The participants in the control group(n¼30)downloaded the Symptom Management(SM)app according to their needs and preferences,and received routine follow-ups.The participants in the intervention group(n¼31)were guided to download and use the SM app,and received four tailored weekly group sessions at routine follow-ups.Each group session lasted for approximately 2 h and targeted one of the major modules of the SM app.All the outcomes were assessed at baseline and post-intervention.The study was registered with the Chinese Clinical Trial Registry(ChiCTR1900024821).Results:The symptom management knowledge and certainty of symptom self-management were significantly improved after the intervention(all P<0.01).Compared with the control group,the scores of symptoms reasons knowledge score improved 11.47 points(95%CI:3.41,19.53)and scores of symptoms self-management knowledge score improved 12.80 points(95%CI:4.55,21.05)in the intervention group after controlling for covariates.However,other outcomes did not show statistically significant differences between the intervention group and the control group(P>0.05).Conclusion:The SMI could improve PLWH’s symptom management knowledge and certainty of symptom self-management.Multi-center studies with larger sample sizes and longer follow-ups are needed to further understand the effects of SM app on ameliorating symptom severity and symptom distress.More innovative strategies are also needed to promote and maintain the sustainability of the SM app.
目的本研究旨在评价一项基于症状管理小组活动和手机应用软件(App)的中国HIV感染者/AIDS患者症状管理干预方案对患者症状管理知识、症状把握度、症状严重程度、症状困扰程度、服药依从性、社会支持及生活质量的影响。方法该研究为平行设计的随机对照试验。在上海招募61例HIV感染者/AIDS患者。对照组患者(n=30)根据他们的需求和偏好下载症状管理App,并接受常规随访。干预组患者(n=31)经研究者指导,下载和使用症状管理App,在常规随访的基础上接受每周1次、共4次的小组课程。每次小组课程大约2 h,对应App的一项主要功能。所有的结局指标均在基线和干预后进行测量。结果干预后两组间症状管理知识和症状把握度的差异有统计学意义(P<0.01)。与对照组相比,在控制协变量后,干预组的症状引发原因知识得分提高11.47分(95%CI:3.41~19.53),症状处理知识得分提高12.80分(95%CI:4.55~21.05)。但其他结局指标的组间差异无统计学意义(P>0.05)。结论基于症状管理小组课程和App的症状管理干预方案能帮助HIV感染者/AIDS患者提升症状管理的知识水平和症状把握度。未来还需开展多中心、大样本、更长时间随访的临床试验来评估症状管理App对帮助HIV感染者/AIDS患者缓解症状严重程度和症状困扰的效果。研究者也需探索更多创新型的策略来促进和维持症状管理App应用的可持续性。
作者
Shuyu Han
Yaolin Pei
Rui Zhao
Yan Hu
Lin Zhang
Xiang Qi
Zheng Zhu
Wenxiu Sun
Bei Wu
韩舒羽;Yaolin Pei;赵蕊;胡雁;张林;Xiang Qi;朱政;孙文秀;Bei Wu(School of Nursing,Fudan University,Shanghai,China;Rory Meyers College of Nursing,New York University,New York,USA;Children's Hospital of Fudan University,Shanghai,China;Fudan University Centre for Evidence-based Nursing:A Joanna Briggs Institute Centre of Excellence,Shanghai,China;Shanghai Public Health Clinical Center Affiliated with Fudan University,Shanghai,China)
基金
This paper is part of a project funded by the National Natural Science Foundation of China(Grant Number 71673057)
the China Scholarship Council(No.201906100135).
