Gachon University, College of Nursing, Republic of Korea.
School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan.
Appl Nurs Res. 2021 Oct;61:151485. doi: 10.1016/j.apnr.2021.151485. Epub 2021 Aug 8.
This systematic review of reviews aims to critically evaluate and synthesize findings from recent systematic reviews to analyze the effectiveness of transitional care interventions in the management of adult patients with chronic illnesses.
Transitional care interventions have been provided to patients with chronic illnesses for reducing fragmented care and hospital readmissions after discharge. However, the effectiveness of the interventions on outcomes other than hospital readmissions is still unclear.
This study used the systematic review of systematic reviews methodology. From five electronic databases, systematic reviews published between January 2011 and December 2020 and those that met the inclusion and exclusion criteria were searched and screened to retrieve recent evidence.
Eight systematic reviews that met the inclusion criteria and had high methodological quality were included. All included transitional care interventions aimed to reduce fragmented care and hospital admissions and improve health care outcomes in chronically ill patients. On summarizing and synthesizing the data, four common outcomes-hospital readmissions, quality of life, mortality, and health care cost savings-were retrieved. There was evidence regarding the effectiveness of transitional care on health care cost savings; however, other outcomes showed mixed results.
Transitional care interventions are effective for patients with chronic illnesses. It is important to have standardized outcome measures; therefore, it is recommended to fund research and reimbursement of transitional care practices. The findings and implications of this review are important to nurse managers, health care practitioners, researchers, and policymakers.
本综述旨在批判性地评估和综合近期系统评价的结果,以分析过渡期护理干预措施在管理慢性疾病成年患者方面的有效性。
为了减少出院后碎片化护理和再次住院,已经向慢性疾病患者提供了过渡期护理干预措施。然而,干预措施对除再次住院以外的结局的有效性仍不清楚。
本研究采用系统评价综述方法。从五个电子数据库中检索并筛选了 2011 年 1 月至 2020 年 12 月期间发表的符合纳入和排除标准的系统评价,以获取最新证据。
共纳入 8 项符合纳入标准且方法学质量较高的系统评价。所有纳入的过渡期护理干预措施旨在减少慢性疾病患者的护理碎片化和住院,并改善医疗保健结局。在总结和综合数据后,我们检索到了四个常见的结局:再次住院、生活质量、死亡率和医疗保健成本节约。有证据表明过渡期护理对医疗保健成本节约有效,但其他结局的结果则存在差异。
过渡期护理干预措施对慢性疾病患者有效。重要的是要有标准化的结局测量指标,因此,建议为过渡期护理实践的研究和报销提供资金。本综述的结果和意义对护士管理者、医疗保健从业者、研究人员和政策制定者都很重要。