Kappes Maria, Espinoza Pilar, Jara Vanessa, Hall Amanda
Faculty of Health Care Sciences, Nursing School, Universidad San Sebastián, Puerto Montt, Chile.
Faculty of Medicine and Science, Universidad San Sebastián, Santiago, Chile.
BMC Nurs. 2023 Jan 17;22(1):19. doi: 10.1186/s12912-022-01170-z.
Hypertension is a public health concern for many countries. The World Health Organization has established a global objective to reduce the prevalence of non-communicable diseases, including hypertension, which is associated with cardiovascular disease. Remote nursing interventions can potentially lessen the burden on the healthcare system and promote a healthier population. This systematic review aims to synthesize available evidence on the effectiveness of nursing-led telehealth interventions in reducing blood pressure in hypertensive patients.
A systematic review was conducted. The search was performed from May to June 2021, in the databases: PubMed, Scopus, Cochrane Library, Web of Science, CINAHL, and ProQuest within 2010-2021 in English, Spanish and Portuguese. Randomized controlled trials and Quasi-experimental studies were considered. This systematic review followed the criteria of the Cochrane Handbook for Systematic Reviews of Interventions, with the support of the PRISMA guidelines and registered in PROSPERO. For critical analysis, the tools of the Joanna Briggs Institute were used.
Of the 942 articles found, six controlled clinical trials and one quasi-experimental study were selected. Different nurse-led interventions (telehealth devices, remote video consultation, calls and email alerts) have demonstrated a significant decrease in blood pressure (especially systolic blood pressure) in the intervention groups. Nurse-led interventions also effect hypertension awareness, self-efficacy, and self-control. Positive effects on lowering cholesterol, consumption of fruits and vegetables, physical activity and adherence to medication were also described.
Nurse-led interventions delivered remotely have a positive effect in lowering the blood pressure of patients with hypertension. Further research is required to support strategies that will deliver the best continuous, quality, and cost-effective nursing care.
高血压是许多国家关注的公共卫生问题。世界卫生组织已制定全球目标，以降低包括高血压在内的非传染性疾病的患病率，高血压与心血管疾病相关。远程护理干预有可能减轻医疗系统的负担，并促进民众更加健康。本系统评价旨在综合现有证据，探讨以护士为主导的远程医疗干预对降低高血压患者血压的有效性。
进行了一项系统评价。于2021年5月至6月在PubMed、Scopus、Cochrane图书馆、科学网、护理学与健康领域数据库（CINAHL）和ProQuest数据库中进行检索，检索2010 - 2021年期间以英文、西班牙文和葡萄牙文发表的文献。纳入随机对照试验和半实验性研究。本系统评价遵循《Cochrane干预措施系统评价手册》的标准，在系统评价和Meta分析的首选报告项目（PRISMA）指南的支持下进行，并在国际前瞻性系统评价注册库（PROSPERO）登记。采用乔安娜·布里格斯循证卫生保健中心的工具进行批判性分析。
在检索到的942篇文章中，选取了6项对照临床试验和1项半实验性研究。不同的以护士为主导的干预措施（远程医疗设备、远程视频会诊、电话和电子邮件提醒）已证明干预组的血压显著下降（尤其是收缩压）。以护士为主导的干预措施还对高血压知晓率、自我效能感和自我控制产生影响。还描述了对降低胆固醇、水果和蔬菜摄入量、身体活动及药物依从性的积极作用。
以护士为主导的远程干预对降低高血压患者的血压有积极作用。需要进一步开展研究，以支持能够提供最佳持续、优质且具有成本效益的护理服务的策略。
