Pulmonary and Critical care Medicine Department, Thoracic Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
BMC Prim Care. 2022 Jun 30;23(1):166. doi: 10.1186/s12875-022-01766-z.
In organ transplantation, all patients must follow a complex treatment regimen for the rest of their lives. Hence, patients play an active role in the continuity of the care process in the form of self-management tasks. Thus, the main objective of our study was to investigate the pragmatic solutions applied by different studies to enhance adherence to self-management behaviors.
A systematic review was conducted in five databases from 2010 to August 2021 using keywords. Eligible studies were all English papers that developed self-management programs to enhance patient care in solid organ transplantation. The interventions were analyzed using thematic analysis to determine the main descriptive areas. The quality of the included articles was evaluated using the research critical appraisal program (CASP) tool.
Of the 691 retrieved articles, 40 met our inclusion criteria. Of these, 32 studies were devoted to the post-transplantation phase. Five main areas were determined (e-health programs for telemonitoring, non-electronic educational programs, non-electronic home-based symptom-monitoring programs, electronic educational plans for self-monitoring, and Telerehabilitation) according to thematic analysis. Most studies (72.5%) declared that developed programs and applied solutions had a statistically significant positive impact on self-management behavior enhancement in transplant patients.
The results showed that an effective solution for improving organ transplantation needs patient collaboration to address psychological, social, and clinical aspects of patient care. Such programs can be applied during candidate selection, waiting list, and after transplantation by putting the patient at the center of care.
在器官移植中，所有患者都必须在余生中遵循复杂的治疗方案。因此，患者通过自我管理任务以积极的方式参与到护理过程的连续性中。因此，我们研究的主要目的是调查不同研究中应用的实用解决方案，以增强对自我管理行为的依从性。
从 2010 年至 2021 年 8 月，我们使用关键词在五个数据库中进行了系统综述。合格的研究均为英文论文，这些论文制定了自我管理计划，以增强实体器官移植患者的护理。使用主题分析对干预措施进行分析，以确定主要描述领域。使用研究批判性评估计划 (CASP) 工具评估纳入文章的质量。
在 691 篇检索到的文章中，有 40 篇符合我们的纳入标准。其中 32 项研究致力于移植后的阶段。根据主题分析确定了五个主要领域（用于远程监测的电子健康计划、非电子教育计划、非电子家庭症状监测计划、用于自我监测的电子教育计划和远程康复）。大多数研究（72.5%）宣称，开发的方案和应用的解决方案对提高移植患者的自我管理行为具有统计学上的显著积极影响。
结果表明，改善器官移植的有效解决方案需要患者协作，以解决患者护理的心理、社会和临床方面的问题。此类方案可以在候选者选择、等待名单和移植后实施，将患者置于护理的中心。
