From the College of Nursing,·Mo-Im Kim Nursing Research Institute,·Yonsei Evidence Based Nursing Center of Korea: A Joanna Briggs Institute Center of Excellence, Yonsei University.
College of Nursing,·Mo-Im Kim Nursing Research Institute, Yonsei University.
J Patient Saf. 2021 Jun 1;17(4):305-310. doi: 10.1097/PTS.0000000000000596.
Teach-back methods are reported to improve patient outcomes by encouraging patient understanding and participation and are increasingly being used in various clinical settings. This study attempts to identify the effectiveness of discharge education using the teach-back method on 30-day readmission.
MEDLINE, CINAHL, Embase, The Cochrane Library, and Web of Science were used to search experimental studies. The search terms were "discharged patient," "teach-back," and "30-day readmission" published in English up until July 2017. Two trained reviewers performed a critical appraisal of retrieved studies using the Risk of Bias Assessment tool for Nonrandomized Studies. Data were analyzed using Cochrane Review Manager (Revman) software 5.2.
A total of five studies were analyzed (3 studies on heart failure, 1 study on total joint replacement, and 1 study on a coronary artery bypass graft). The main content of the teach-back education was to confirm and reinforce the patients' comprehension of health-related information. Among the five studies, three studies were included in the meta-analysis. The odds ratio of 30-day readmission for discharge education with the teach-back method and usual care was 0.55 (95% confidence interval, 0.34-0.91; P = 0.02). The I2 score was 0%, which means that the analyzed studies are homogeneous.
The results indicate that discharge education with the teach-back method resulted in a 45% reduction in 30-day readmission. However, only a few studies were included in the analysis, and they showed a high risk of selection bias. Therefore, we suggest that well-designed randomized controlled trials be conducted.
回述教学法通过鼓励患者理解和参与，据报道可以改善患者结局，并且正在各种临床环境中得到越来越多的应用。本研究旨在确定回述教学法在出院教育中对 30 天再入院的影响。
使用 MEDLINE、CINAHL、Embase、The Cochrane Library 和 Web of Science 检索英文发表的实验研究。检索词为“出院患者”、“回述”和“30 天再入院”，检索时限截至 2017 年 7 月。两名经过培训的评审员使用非随机研究偏倚风险评估工具对检索到的研究进行了严格评价。使用 Cochrane 评论管理软件（Revman）5.2 对数据进行分析。
共分析了 5 项研究（3 项心力衰竭研究、1 项全关节置换研究和 1 项冠状动脉旁路移植术研究）。回述教学的主要内容是确认和加强患者对健康相关信息的理解。在这 5 项研究中，有 3 项研究被纳入荟萃分析。回述教学法与常规护理相比，30 天再入院的优势比为 0.55（95%置信区间，0.34-0.91；P = 0.02）。I2 评分 0%，表明分析研究具有同质性。
结果表明，回述教学法可使 30 天再入院率降低 45%。然而，分析中仅纳入了少数几项研究，这些研究存在选择偏倚的高度风险。因此，我们建议进行精心设计的随机对照试验。
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