School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
J Med Internet Res. 2022 Mar 21;24(3):e31912. doi: 10.2196/31912.
In recent years, telehealth has become a common channel for health care professionals to use to promote health and provide distance care. COVID-19 has further fostered the widespread use of this new technology, which can improve access to care while protecting the community from exposure to infection by direct personal contact, and reduce the time and cost of traveling for both health care users and providers. This is especially true for community-dwelling older adults who have multiple chronic diseases and require frequent hospital visits. Nurses are globally recognized as health care professionals who provide effective community-based care to older adults, facilitating their desire to age in place. However, to date, it is unclear whether the use of telehealth can facilitate their work of promoting self-care to community-dwelling older adults.
This review aims to summarize findings from randomized controlled trials on the effect of nurse-led telehealth self-care promotion programs compared with the usual on-site or face-to-face services on the quality of life (QoL), self-efficacy, depression, and hospital admissions among community-dwelling older adults.
A search of 6 major databases was undertaken of relevant studies published from May 2011 to April 2021. Standardized mean differences (SMDs) and their 95% CIs were calculated from postintervention outcomes for continuous data, while the odds ratio was obtained for dichotomous data using the Mantel-Haenszel test.
From 1173 possible publications, 13 trials involving a total of 4097 participants were included in this meta-analysis. Compared with the control groups, the intervention groups of community-dwelling older adults significantly improved in overall QoL (SMD 0.12; 95% CI 0.03 to 0.20; P=.006; I=21%), self-efficacy (SMD 0.19; 95% CI 0.08 to 0.30; P<.001; I=0%), and depression level (SMD -0.22; 95% CI -0.36 to -0.08; P=.003; I=89%).
This meta-analysis suggests that employing telehealth in nurse-led self-care promotion programs may have a positive impact on older adults, although more studies are needed to strengthen the evidence base, particularly regarding organization and delivery.
PROSPERO (Prospective International Register of Systematic Reviews) CRD42021257299; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=257299.
近年来，远程医疗已成为医疗保健专业人员促进健康和提供远程护理的常用渠道。COVID-19 进一步推动了这项新技术的广泛应用，它可以改善医疗服务的可及性，同时保护社区免受直接人际接触感染的风险，并减少医疗保健使用者和提供者旅行的时间和成本。对于那些患有多种慢性病且需要频繁住院的社区居住的老年人来说，更是如此。护士是全球公认的为老年人提供有效社区护理的专业人员，他们能够促进老年人就地养老的愿望。然而，迄今为止，尚不清楚远程医疗的使用是否能够促进护士主导的远程自我护理促进计划为社区居住的老年人提供服务，提高他们的自我护理能力。
本综述旨在总结 2011 年 5 月至 2021 年 4 月期间发表的关于护士主导的远程健康自我护理促进计划与常规现场或面对面服务对社区居住的老年人生活质量（QoL）、自我效能、抑郁和住院率影响的随机对照试验的结果。
对 6 个主要数据库进行了检索，以查找 2011 年 5 月至 2021 年 4 月发表的相关研究。对连续性数据，采用标准化均数差（SMD）及其 95%置信区间（CI）进行分析；对二分类数据，采用 Mantel-Haenszel 检验获得比值比。
从 1173 篇可能的文献中，共有 13 项试验纳入了 4097 名参与者，本荟萃分析对其进行了分析。与对照组相比，社区居住的老年人的干预组在总体 QoL（SMD 0.12；95%CI 0.03 至 0.20；P=.006；I=21%）、自我效能（SMD 0.19；95%CI 0.08 至 0.30；P<.001；I=0%）和抑郁程度（SMD -0.22；95%CI -0.36 至 -0.08；P=.003；I=89%）方面均有显著改善。
本荟萃分析表明，在护士主导的自我护理促进计划中采用远程医疗可能对老年人产生积极影响，但仍需要更多研究来加强证据基础，特别是在组织和实施方面。
PROSPERO（前瞻性国际系统评价登记库）CRD42021257299；https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=257299。
