Department of Nursing, People's Hospital of Tongling City, Tongling, Anhui, China.
Attending doctor of Department of Gastrointestinal Surgery, People's Hospital of Tongling City, Tongling, Anhui, China.
PLoS One. 2018 Aug 28;13(8):e0202326. doi: 10.1371/journal.pone.0202326. eCollection 2018.
WeChat is a smartphone application that may help patients self-manage peripherally inserted central catheters (PICC), although additional data are needed regarding this topic. This systematic review and meta-analysis aimed to determine whether WeChat helped improve PICC-related complications, self-care ability, PICC maintenance dependency in that the behavior of a patient is in compliance with a doctor's order or a will, knowledge mastery, and satisfaction among patients with a PICC. The PubMed, Embase, Cochrane Library, China Biology Medicine, China national Knowledge Infrastructure, Wanfang, Wiper, and Baidu Scholar databases were searched to identify related reports that were published up to April 2018. This search revealed 36 reports that were published during 2014-2018, including 2,623 controls and 2,662 patients who used the WeChat application. Relative to the traditional follow-up group, the group that received WeChat follow-up had a lower risk of PICC-related complications (odds ratio [OR]: 0.23, 95% confidence interval [CI]: 0.19-0.27, P < 0.00001), better self-care ability (mean difference: 36.41, 95% CI: 34.68-38.14, P < 0.00001), higher PICC maintenance dependency (OR: 4.27, 95% CI: 3.35-5.44, P < 0.00001), and higher patient satisfaction (OR: 6.20, 95% CI: 4.32-8.90, P < 0.00001). Eight studies reported knowledge mastery, although the different evaluation tools precluded a meta-analysis. Nevertheless, those eight studies revealed that knowledge mastery was significantly higher in the WeChat group than in the traditional follow-up group (P < 0.05). To the best of our knowledge, this is the first meta-analysis to evaluate the effects of WeChat follow-up on self-management among patients who are discharged with a PICC. It appears that WeChat follow-up can help improve the incidence of complications, self-care ability, PICC maintenance dependence, and patient satisfaction. However, the WeChat application itself cannot improve patients' self-management ability. Further studies are needed to produce high-quality evidence to determine whether WeChat is an effective follow-up tool.
微信是一款智能手机应用程序，它可能有助于患者自我管理外周静脉置入中心导管（PICC），尽管关于这个话题还需要更多的数据。本系统评价和荟萃分析旨在确定微信是否有助于降低 PICC 相关并发症的发生率，提高患者自我护理能力、PICC 维护依赖性（患者的行为符合医嘱或意愿）、知识掌握程度和对 PICC 患者的满意度。研究人员检索了 PubMed、Embase、Cochrane 图书馆、中国生物医学文献数据库、中国知网、万方、维普和百度学术等数据库，以查找截至 2018 年 4 月发表的相关报告。该检索共发现 36 篇 2014-2018 年期间发表的报告，包括 2623 例对照组和 2662 例使用微信应用程序的患者。与传统随访组相比，接受微信随访的患者 PICC 相关并发症的发生率较低（比值比 [OR]：0.23，95%置信区间 [CI]：0.19-0.27，P < 0.00001），自我护理能力较好（均数差：36.41，95% CI：34.68-38.14，P < 0.00001），PICC 维护依赖性较高（OR：4.27，95% CI：3.35-5.44，P < 0.00001），患者满意度较高（OR：6.20，95% CI：4.32-8.90，P < 0.00001）。有 8 项研究报告了知识掌握情况，但不同的评估工具使得无法进行荟萃分析。然而，这 8 项研究表明，微信组的知识掌握程度明显高于传统随访组（P < 0.05）。据我们所知，这是第一项评估微信随访对带管出院患者自我管理影响的荟萃分析。微信随访似乎可以帮助降低并发症发生率、提高自我护理能力、PICC 维护依赖性和患者满意度。但是，微信应用程序本身并不能提高患者的自我管理能力。需要进一步的高质量研究来确定微信是否是一种有效的随访工具。
