College of Nursing, Rush University, Chicago, Illinois.
Cooper Scientific and Editorial Consulting, Columbia, Missouri.
J Adv Nurs. 2019 Mar;75(3):676-682. doi: 10.1111/jan.13903. Epub 2018 Dec 21.
To synthesize and compare outcomes from controlled trials of interventions to improve heart failure self-care among adults.
Heart failure self-care interventions are recommended for preventing and detecting exacerbations, improving symptom management and preventing hospitalizations. Little is known about the overall effectiveness of heart failure self-care programmes and which types of interventions show the greatest improvement in outcomes.
Systematic review and meta-analysis, including moderator analyses.
Multiple databases (including MEDLINE/PubMed, CINAHL, PsycINFO, Scopus and Cochrane Central Register of Controlled Trials) will be searched from inception through 2018 along with grey literature searches to identify trials testing interventions to improve self-care outcomes of adults with heart failure. Data will be extracted from eligible studies on sample, methodological and intervention characteristics and data to calculate effect sizes. Data will be analysed using random-effects models. Moderator variables will be analysed with meta-regression and sub-group analyses. Risk for bias will be assessed using the Cochrane Risk for Bias tool and by examining potential sources of bias as moderator variables. Funding for this project began in July 2017.
We will analyse self-care behaviour outcomes and clinical outcomes including hospitalizations, mortality, disease severity and quality of life. This will be the most extensive meta-analysis of heart failure self-care interventions to date.
Comparative effectiveness of existing self-care interventions is not yet known. This research will identify the most promising self-care intervention components for designing better interventions and guide targeting of interventions to specific sub-populations. PROSPERO Registration Number: CRD42017075831.
综合比较改善成人心力衰竭自我护理干预措施的对照试验结果。
推荐心力衰竭自我护理干预措施，以预防和发现恶化，改善症状管理并预防住院。对于心力衰竭自我护理方案的总体有效性以及哪种干预措施在改善结果方面效果最好，人们知之甚少。
系统评价和荟萃分析，包括调节因素分析。
将从最初开始在多个数据库（包括 MEDLINE/PubMed、CINAHL、PsycINFO、Scopus 和 Cochrane 对照试验中心注册库）以及灰色文献搜索中搜索，以确定测试干预措施以改善成年人心力衰竭自我护理结果的试验。将从合格研究中提取样本、方法学和干预特征以及数据，以计算效应量。使用随机效应模型分析数据。使用荟萃回归和亚组分析分析调节变量。使用 Cochrane 偏倚风险工具评估偏倚风险，并通过检查潜在的偏倚来源作为调节变量来评估潜在的偏倚来源。该项目的资助始于 2017 年 7 月。
我们将分析自我护理行为结果和临床结果，包括住院、死亡率、疾病严重程度和生活质量。这将是迄今为止对心力衰竭自我护理干预措施进行的最广泛的荟萃分析。
现有的自我护理干预措施的相对有效性尚不清楚。这项研究将确定最有前途的自我护理干预措施组成部分，用于设计更好的干预措施，并指导针对特定亚人群的干预措施。PROSPERO 注册号：CRD42017075831。
