系统性红斑狼疮患者出院准备服务方案的构建及效果评价

doi:10.3761/j.issn.1672-9234.2025.06.015

摘要/Abstract

摘要：

目的构建系统性红斑狼疮（systemic lupus erthematosus，SLE）患者出院准备服务方案并初步验证其有效性。方法基于从SLE患者出院准备服务最佳证据中提取出的条目，通过半结构化访谈、专家函询和研究小组讨论，确定SLE患者出院准备服务方案。采用便利抽样法，选择2024年3月—6月合肥市某三级甲等医院收治的SLE患者43例为研究对象。其中2024年5—6月收治的20例患者为试验组，在常规护理基础上对其实施SLE患者出院准备服务方案，2024年3月—4月收治的23例患者为对照组，对其实施常规护理。比较两组出院准备度、出院指导质量。结果试验组出院准备度、出院指导质量得分高于对照组（P<0.001）。结论构建的SLE患者出院准备服务方案可有效提高患者的出院准备度、出院指导质量。

关键词: 系统性红斑狼疮, 循证护理学, 德尔菲技术, 出院准备服务

Abstract:

Objective To develop a discharge preparation service program for patients with systemic lupus erythematosus（SLE） and initially verify its effects. Methods Based on the best evidence for discharge preparation services for SLE patients，semi-structured interviews，experts consultation，and research group discussion were conducted to establish the discharge preparation service program for SLE patients. A total of 43 SLE patients admitted to a tertiary hospital in Hefei City were recruited by convenience sampling. Among them，23 patients admitted from March 2024 to April 2024 were assigned to the control group and received routine care. The remaining 20 patients admitted between May 2024 and June 2024 were assigned to the experimental group and received the SLE discharge preparation service program in addition to routine care. The readiness for hospital discharge and quality of discharge instructions were compared between the two groups. Results The scores of readiness for hospital discharge and quality of discharge instructions in the experimental group were higher than those in the control group（P<0.001）. Conclusion The developed discharge preparation service program for SLE patients can effectively improve patients’ readiness for hospital discharge and the quality of discharge instructions.

Key words: Systemic Lupus Erythematosus, Evidence Based Nursing, Delphi Technology, Discharge Preparation Services

刘书婷, 郝敏, 陈佩玲, 夏雪迎, 宋子成, 胡佳佳, 赵薇. 系统性红斑狼疮患者出院准备服务方案的构建及效果评价[J]. 中华护理教育, 2025, 22(6): 732-739.

LIU Shuting, HAO Min, CHEN Peiling, XIA Xueying, SONG Zicheng, HU Jiajia, ZHAO Wei. Construction and effects evaluation of a discharge preparation service program for patients with systemic lupus erythematosus[J]. Chinese Journal of Nursing Education, 2025, 22(6): 732-739.

图/表 4

参考文献 21

[1]	Durcan L, O’Dwyer T, Petri M. Management strategies and future directions for systemic lupus erythematosus in adults[J]. Lancet, 2019, 393(10188):2332-2343. doi: S0140-6736(19)30237-5 pmid: 31180030
[2]	Li MT, Zhao Y, Zhang ZY, et al. 2020 Chinese guidelines for the diagnosis and treatment of systemic lupus erythematosus[J]. Rheumatol Immunol Res,2020, 1(1):5-23.
[3]	罗帅寒天, 龙海, 张桂英, 等. 2019年系统性红斑狼疮研究新进展[J]. 中华皮肤科杂志, 2021, 54(2):183-186.
[4]	Cheng YJ, Li MT, Zhao JL, et al. Chinese SLE treatment and research group(CSTAR) registry:VIII. influence of socioecono-mic and geographical variables on disease phenotype and activity in Chinese patients with SLE[J]. Int J Rheum Dis, 2018, 21(3):716-724.
[5]	Zen M, Salmaso L, Barbiellini Amidei C, et al. Mortality and causes of death in systemic lupus erythematosus over the last decade:data from a large population-based study[J]. Eur J Intern Med, 2023, 112:45-51.
[6]	Barber MRW, Clarke AE. Systemic lupus erythematosus and risk of infection[J]. Expert Rev Clin Immunol, 2020, 16(5):527-538.
[7]	喻雅婷, 肖峰, 陈俊如, 等. 出院准备服务护理临床实践与研究进展[J]. 中国实用护理杂志, 2018, 34(2):139-143.
[8]	Gonçalves-Bradley DC, Lannin NA, Clemson L, et al. Discharge planning from hospital[J]. Cochrane Database Syst Rev, 2022, 2(2):CD000313.
[9]	Xie X, Song YQ, Yang H, et al. Effects of transitional care on self-care,readmission rates,and quality of life in adult patients with systemic lupus erythematosus:a randomized controlled trial[J]. Arthritis Res Ther, 2018, 20(1):184.
[10]	刘书婷, 郝敏, 陈佩玲, 等. 系统性红斑狼疮病人出院准备服务的最佳证据总结[J]. 循证护理, 2024, 10(23):4210-4218.
[11]	Billingham SAM, Whitehead AL, Julious SA. An audit of sample sizes for pilot and feasibility trials being undertaken in the United Kingdom registered in the United Kingdom Clinical Research Network database[J]. BMC Med Res Methodol, 2013, 13:104. doi: 10.1186/1471-2288-13-104 pmid: 23961782
[12]	Weiss ME, Piacentine LB. Psychometric properties of the rea-diness for hospital discharge scale[J]. J Nurs Meas, 2006, 14(3):163-180.
[13]	Lin SC, Cheng SJ, Shih SC, et al. The past,present,and future of discharge planning in Taiwan[J]. Int J Gerontol, 2013, 7(2):65-69.
[14]	王冰花, 汪晖, 杨纯子. 中文版出院指导质量量表的信效度测评[J]. 中华护理杂志, 2016, 51(6):752-755.
[15]	刘名君, 吴丹, 吴德全, 等. 基于三维质量结构理论对PICC护理质量评价指标体系的构建[J]. 护理学杂志, 2017, 32(21):39-42.
[16]	周玥, 颜巧元. 肠造口病人出院准备度现状及其影响因素研究[J]. 护理研究, 2019, 33(11):1827-1832.
[17]	牟文轩. 老年食管癌放疗患者出院准备度、家庭功能、医学应对方式、出院指导质量间的关系研究[D]. 成都: 成都医学院, 2023.
[18]	陈琴, 姜小鹰, 钟清玲, 等. 慢性阻塞性肺疾病患者应用出院计划服务的效果评价[J]. 中华护理杂志, 2012, 47(9):790-794.
[19]	Facchinetti G, Ianni A, Piredda M, et al. Discharge of older patients with chronic diseases:what nurses do and what they record. An observational study[J]. J Clin Nurs, 2019, 28(9/10):1719-1727.
[20]	蔡闵敏, 张春, 张洁琼, 等. 慢性病患者信息过载的概念分析[J]. 中华护理教育, 2025, 22(1):122-128.
[21]	Alper E, O’Malley TA, Greenwald J. Hospital discharge and readmission[EB/OL].(2023-02-03)[2023-08-03]. https://www.uptodate.com/contents/hospital-discharge-and-readmission.