College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia.
J Telemed Telecare. 2024 Jun;30(5):781-794. doi: 10.1177/1357633X221102264. Epub 2022 Jun 3.
Traumatic brain injury (TBI) represents a major cause of death and disability worldwide. Brain damage is associated with physical and psychological difficulties among TBI survivors. Diverse face-to-face and telehealth programs exist to help survivors cope with these burdens. However, the effectiveness of telehealth interventions among TBI survivors remains inconclusive.
A systematic review and meta-analysis of randomized control trials were conducted. Relevant full-text articles were retrieved from seven databases, from database inception to January 2022, including Academic Search Complete, CINAHL, EMBASE, Cochrane, MEDLINE, PubMed, and Web of Science. Bias was assessed with the revised Cochrane risk-of-bias tool for randomized trials. A meta-analysis was performed using a random-effects model to calculate the pooled effect size of telehealth interventions for TBI survivors. STATA 16.0 was used for statistical analysis.
In total, 17 studies ( = 3158) applying telehealth interventions among TBI survivors were included in the analysis. Telehealth interventions decreased neurobehavioural symptom (standardized mean difference: -0.13; 95% confidence interval [CI]: -0.36 to 0.10), reduce depression (standardized mean difference: -0.32; 95% CI: -0.79 to 0.14), and increase symptom management self-efficacy (standardized mean difference: 0.22; 95% CI: 0.02-0.42).
Telehealth interventions are promising avenues for healthcare delivery due to advances in technology and information. Telehealth programs may represent windows of opportunity, combining traditional treatment with rehabilitation to increase symptom management self-efficacy among TBI patients during recovery. Future telehealth programs can focus on developing the contents of telehealth modules based on evidence from this study.
创伤性脑损伤（TBI）是全球范围内主要的死亡和残疾原因。脑损伤与 TBI 幸存者的身体和心理困难有关。存在各种面对面和远程医疗计划来帮助幸存者应对这些负担。然而，远程医疗干预对 TBI 幸存者的有效性仍不确定。
对随机对照试验进行了系统评价和荟萃分析。从七个数据库中检索到相关的全文文章，从数据库成立到 2022 年 1 月，包括 Academic Search Complete、CINAHL、EMBASE、Cochrane、MEDLINE、PubMed 和 Web of Science。使用修订后的 Cochrane 随机对照试验偏倚风险工具评估偏倚。使用随机效应模型进行荟萃分析，以计算 TBI 幸存者远程医疗干预的汇总效应大小。使用 STATA 16.0 进行统计分析。
共有 17 项研究（ = 3158）纳入了 TBI 幸存者的远程医疗干预措施。远程医疗干预措施可减少神经行为症状（标准化均数差：-0.13；95%置信区间[CI]：-0.36 至 0.10）、降低抑郁（标准化均数差：-0.32；95% CI：-0.79 至 0.14）和增加症状管理自我效能感（标准化均数差：0.22；95% CI：0.02-0.42）。
由于技术和信息的进步，远程医疗干预措施是提供医疗保健的有前途的途径。远程医疗计划可能代表着机会之窗，将传统治疗与康复相结合，在 TBI 患者康复期间提高症状管理自我效能感。未来的远程医疗计划可以根据本研究的证据，专注于开发远程医疗模块的内容。
