Cheng Xiuju, Wei Shougang, Zhang Huapeng, Xue Senyao, Wang Wei, Zhang Kaikai
Department of Public Health Department of Pediatric Internal Medicine Department of Anesthesiology Department of General Surgery Department of Interventional Therapy, Yidu Central Hospital of Weifang, Qingzhou City, Shandong, China.
Medicine (Baltimore). 2018 Aug;97(34):e12037. doi: 10.1097/MD.0000000000012037.
To compare the quality of life outcome between nurse-led and non-nurse-led interventions for patients with cancer using a meta-analysis.
A systematic literature review was performed by searching randomized controlled trials about nurse-led interventions in PubMed, EMBASE, and Cochrane Library databases until June 2017. Pooled summary estimates for quality of life outcome was calculated as standardized mean difference (SMD) either on a fixed- or random-effect model via Stata 13.0 software.
Seven literatures involving 1110 patients (554 in the nurse-led group and 556 in the control group) were included. Pooled analysis showed there were no differences in the global quality of life, cognitive, emotional, role, social and physical functions, appetite loss, diarrhea, and dyspnea scales of Quality of Life Questionnaire C30 version 3.0 core (QLQ-C30) questionnaires between the nurse-led and control groups. However, the nurse-led management program significantly decreased the occurrence of constipation (SMD = -0.36, 95% CI = -0.71 to -0.00; P = .001) and insomnia (SMD = -0.33, 95% CI = -0.99 to 0.32; P = .011) and reduced the financial difficulty (SMD = -0.34, 95% CI = -0.65 to -0.03; P = .033) for patients with cancer.
The nurse-led disease management strategy seemed to be effective to improve constipation, insomnia, and financial impacts for patients with cancer in quality of life assessment.
通过荟萃分析比较由护士主导和非护士主导的干预措施对癌症患者生活质量的影响。
通过检索PubMed、EMBASE和Cochrane图书馆数据库中截至2017年6月的关于护士主导干预措施的随机对照试验，进行系统的文献综述。使用Stata 13.0软件，在固定效应或随机效应模型上计算生活质量结果的合并汇总估计值，以标准化均数差值（SMD）表示。
纳入了7篇文献，涉及1110名患者（护士主导组554名，对照组556名）。汇总分析显示，在生活质量问卷C30第3.0版核心问卷（QLQ-C30）的总体生活质量、认知、情感、角色、社会和身体功能、食欲减退、腹泻和呼吸困难量表方面，护士主导组和对照组之间没有差异。然而，护士主导的管理方案显著降低了便秘的发生率（SMD = -0.36，95%CI = -0.71至-0.00；P = 0.001）和失眠的发生率（SMD = -0.33，95%CI = -0.99至0.32；P = 0.011），并减轻了癌症患者的经济困难（SMD = -0.34，95%CI = -0.65至-0.03；P = 0.033）。
在生活质量评估中，护士主导的疾病管理策略似乎能有效改善癌症患者的便秘、失眠和经济影响。
