From the College of Nursing, Chungnam National University, Daejeon, Republic of Korea.
J Patient Saf. 2021 Mar 1;17(2):131-140. doi: 10.1097/PTS.0000000000000714.
The aims of the study were to evaluate and to quantify the effects of patient and family involvement (PFI) interventions on patient safety by synthesizing the available global data.
Four databases were searched to identify relevant studies that have assessed the impact of PFI on patient safety up to March 2019. Reference lists of potential selected articles were also used to identify additional relevant studies. Effect sizes (ESs) were calculated using random and fixed effects models. Statistical heterogeneity was measured using the I2 test.
Twenty-two studies met the review criteria. The meta-analysis showed that PFI were beneficial in significantly reducing adverse events (ES = -0.240, P < 0.001), decreasing the length of hospital stay (ES = -0.122, P < 0.001), increasing patient safety experiences (ES = 0.630, P = 0.007), and improving patient satisfaction (ES = 0.268, P = 0.004). However, the PFI interventions did not significantly enhance the perception of patient safety (ES = 0.205, P = 0.09) or the quality of life (ES = 0.057, P = 0.61). Moreover, moderate-to-high heterogeneity was found for all impacts except adverse events (I2 = 0%) and length of hospital stay (I2 = 35%). A funnel plot indicated a low degree of publication bias for the adverse event outcome.
The synthesized evidence in this review demonstrates the benefits of PFI for promoting patient safety. However, further studies should extend the research scope to fill the existing gaps for both the type of PFI interventions and the patient safety outcomes.
本研究旨在通过综合现有全球数据，评估和量化患者和家属参与（PFI）干预对患者安全的影响。
检索了四个数据库，以确定截至 2019 年 3 月评估 PFI 对患者安全影响的相关研究。还使用潜在选定文章的参考文献列表来确定其他相关研究。使用随机和固定效应模型计算效应大小（ES）。使用 I2 检验测量统计异质性。
符合审查标准的有 22 项研究。荟萃分析表明，PFI 显著有利于减少不良事件（ES = -0.240，P < 0.001），缩短住院时间（ES = -0.122，P < 0.001），增加患者安全体验（ES = 0.630，P = 0.007），提高患者满意度（ES = 0.268，P = 0.004）。然而，PFI 干预并没有显著提高患者对安全的感知（ES = 0.205，P = 0.09）或生活质量（ES = 0.057，P = 0.61）。此外，除不良事件（I2 = 0%）和住院时间（I2 = 35%）外，所有结果均存在中高度异质性。漏斗图表明不良事件结果的发表偏倚程度较低。
本综述综合证据表明，PFI 有助于促进患者安全。然而，进一步的研究应扩大研究范围，以填补 PFI 干预类型和患者安全结果方面的现有空白。
