Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
Speech Pathology, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
BMC Cardiovasc Disord. 2020 Jul 11;20(1):332. doi: 10.1186/s12872-020-01602-1.
As the need for health care services rise, alternative service delivery models such as student-led health interventions become attractive alternatives to alleviate the burden on healthcare. Predominantly, student-led health interventions were free clinics servicing socially disadvantaged communities in the USA. A 2015 systematic review identified that students value these student-run clinics and reported skill and knowledge attainment from participating. Previous research has reported on patient satisfaction outcomes, but less frequently about the clinical outcomes patients accrue from these student-delivered services. As cardiovascular disease is the leading cause of death worldwide, this review aimed to explore the effectiveness of student-led health interventions through examining their impact on objective clinical outcomes, using the case of patients at risk of, or with, cardiovascular disease.
A systematic literature search was conducted in eight electronic databases to identify student-led health interventions conducted on adults with a cardiovascular disease risk factor or established cardiovascular disease, and a clinical outcome of interest. Through double-blinded screening and data extraction, sixteen studies were identified for synthesis.
The majority of student-led health interventions for patients at risk of cardiovascular disease demonstrated a positive impact on patient health. Statistically significant changes amongst patients at risk of cardiovascular disease appeared to be associated with student-led individualised intervention or group-based interventions amongst patients with diabetes or those who are overweight or obese. The evidence was of moderate quality, as included studies lacked a control group for comparison and detail to enable the intervention to be replicated.
Future research applying a student-led health intervention through a randomised control trial, with rigorous reporting of both student and patient interventions and outcomes, are required to further understand the effectiveness of this alternative service delivery model.
随着对医疗保健服务需求的增加，替代服务提供模式（如学生主导的健康干预措施）成为减轻医疗保健负担的有吸引力的选择。主要的学生主导的健康干预措施是在美国为社会弱势群体提供服务的免费诊所。2015 年的一项系统评价确定，学生重视这些由学生管理的诊所，并报告了参与其中获得的技能和知识。以前的研究报告了患者满意度结果，但较少涉及患者从这些由学生提供的服务中获得的临床结果。由于心血管疾病是全球范围内导致死亡的主要原因，因此本研究旨在通过研究学生主导的健康干预措施对有心血管疾病风险或患有心血管疾病的患者的客观临床结果的影响，来探讨其有效性。
在八个电子数据库中进行了系统文献检索，以确定针对有心血管疾病风险因素或已确诊心血管疾病的成年人进行的学生主导的健康干预措施，以及相关的临床结果。通过双盲筛选和数据提取，确定了十六项研究进行综合分析。
大多数针对有心血管疾病风险的患者的学生主导的健康干预措施显示出对患者健康的积极影响。在有心血管疾病风险的患者中，统计上显著的变化似乎与学生主导的个体化干预或针对糖尿病患者或超重或肥胖患者的小组干预有关。证据质量为中等，因为纳入的研究缺乏对照组进行比较，且缺乏细节以使干预措施能够被复制。
未来的研究需要通过随机对照试验应用学生主导的健康干预措施，并严格报告学生和患者的干预措施和结果，以进一步了解这种替代服务提供模式的有效性。
