Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Western Ave, Camperdown, NSW, 2050, Australia.
Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Eur J Cardiovasc Nurs. 2022 Oct 14;21(7):643-654. doi: 10.1093/eurjcn/zvac001.
Patient education is a cardiac rehabilitation core component and is associated with improvements in self-management of patients with coronary heart disease (CHD). However, the efficacy of such interventions on psychosocial outcomes and relative impact of duration is less clear.
This study aimed to assess the efficacy of patient education for secondary prevention related to behaviour change and risk factor modification on psychological outcomes in CHD patients.
A systematic review and meta-analysis.
PsycINFO, CINAHL, Embase, EmCare, MEDLINE, PubMed, and the Cochrane Central Register of Controlled Trials were searched from inception to February 2021.
Randomized controlled trials (RCTs) evaluating patient education in CHD patients, or following myocardial infarction, or revascularization compared with usual care were identified. Outcomes included depression and anxiety at <6 and 6-12 months of follow-up.
A total of 39 RCTs and 8748 participants were included. Patient education significantly improved participants' depressive symptoms at <6 (SMD -0.82) and 6-12 months (SMD -0.38) of follow-up and anxiety level at <6 (SMD -0.90), and 6-12 months (SMD -0.32) of follow-up. Patient education also reduced the risk for having clinical depression by 35% and anxiety by 60%. Longer patient education of ≥3 months, resulted in more improvement in depressive symptoms at 6-12 months (coefficient -0.210) compared to shorter duration.
Patient education for secondary prevention reduces anxiety and depressive symptoms in CHD patients. Regardless of intensity, longer patient education improves depression more than short duration. More information is needed on the relative impact of other intervention components.
PROSPERO (CRD42020200504).
患者教育是心脏康复的核心组成部分，可改善冠心病（CHD）患者的自我管理。然而，这种干预对心理结果的效果以及持续时间的相对影响尚不清楚。
本研究旨在评估针对冠心病患者二级预防相关行为改变和危险因素修正的患者教育对心理结果的疗效。
系统评价和荟萃分析。
从建库到 2021 年 2 月，在 PsycINFO、CINAHL、Embase、EmCare、MEDLINE、PubMed 和 Cochrane 对照试验中心注册库中进行了检索。
评估冠心病患者患者教育的随机对照试验（RCT），或在心肌梗死或血运重建后与常规护理相比，确定了纳入标准。结果包括 6 个月和 12 个月随访时的抑郁和焦虑。
共纳入 39 项 RCT 和 8748 名参与者。患者教育显著改善了患者 6 个月（SMD-0.82）和 12 个月（SMD-0.38）随访时的抑郁症状和 6 个月（SMD-0.90）、12 个月（SMD-0.32）的焦虑水平。患者教育还降低了 35%的临床抑郁风险和 60%的焦虑风险。≥3 个月的患者教育时间更长，在 6-12 个月时改善抑郁症状的效果更好（系数-0.210），而持续时间较短。
针对二级预防的患者教育可减轻冠心病患者的焦虑和抑郁症状。无论强度如何，较长的患者教育都比短时间的教育更能改善抑郁。需要更多关于其他干预措施的相对影响的信息。
PROSPERO（CRD42020200504）。
