Srisuk Nittaya, Cameron Jan, Ski Chantal F, Thompson David R
Centre for the Heart and Mind, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; Faculty of Nursing, Surat Thani Rajabhat University, Surat Thani, Thailand.
Centre for the Heart and Mind, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
Patient Educ Couns. 2016 Mar;99(3):326-338. doi: 10.1016/j.pec.2015.10.009. Epub 2015 Oct 22.
To systematically review evidence for the efficacy of family-based education for heart failure (HF) patients and carers.
A systematic review was conducted. Databases CINAHL, MEDLINE Complete, Cochrane, PubMed, Web of Science, EMBASE, PsycINFO, and Scopus were searched between 1 January 2005 and 1 May 2015. Randomised controlled trials included HF patient and carer dyads or carers alone. The primary outcome was HF knowledge. Secondary outcomes included self-care behaviour, dietary and treatment adherence, quality of life, depression, perceived control, hospital readmissions, and carer burden.
Six trials reported in nine papers were included. Wide variation in the quality of the studies was found. Two studies only examined HF knowledge; a significant improvement among patients and carers was reported. Other significant findings were enhanced patient self-care, boosted dietary and treatment adherence, enriched patient quality of life, improved perceived control among patients but not carers, and reduced carer burden
Modest evidence was found for family-based education among HF patients and carers. Methodological shortcomings of trials signify the need for empirically sound future research.
Family-based HF education needs to include strategies that are tailored to the HF patient and carer, and sustainable in nature.
系统评价针对心力衰竭（HF）患者及其照顾者的家庭式教育效果的证据。
进行了一项系统评价。检索了2005年1月1日至2015年5月1日期间的CINAHL、MEDLINE Complete、Cochrane、PubMed、Web of Science、EMBASE、PsycINFO和Scopus数据库。纳入的随机对照试验包括HF患者及其照顾者二元组或仅照顾者。主要结局是HF知识。次要结局包括自我护理行为、饮食和治疗依从性、生活质量、抑郁、感知控制、住院再入院率和照顾者负担。
纳入了9篇论文中报道的6项试验。发现研究质量差异很大。两项研究仅考察了HF知识；报告称患者和照顾者有显著改善。其他显著发现包括患者自我护理得到加强、饮食和治疗依从性提高、患者生活质量改善、患者（而非照顾者）的感知控制得到改善以及照顾者负担减轻。
发现了关于HF患者及其照顾者家庭式教育的适度证据。试验的方法学缺陷表明未来需要进行实证合理的研究。
基于家庭的HF教育需要包括针对HF患者及其照顾者量身定制且具有可持续性的策略。
