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护士主导的多学科干预措施在初级卫生保健中的有效性:一项系统评价和荟萃分析。

Effectiveness of nurse-led multidisciplinary interventions in primary health care: A systematic review and meta-analysis.

作者信息

Lei Yan-Yuan, Ya Sa Ren Tuo, Zheng Yu-Rong, Cui Xiang-Shu

机构信息

School of Nursing, Yanbian University, Yanji City, China.

出版信息

Int J Nurs Pract. 2023 Dec;29(6):e13133. doi: 10.1111/ijn.13133. Epub 2023 Jan 19.

Abstract

AIM

This review aimed to synthesize the available evidence on the effectiveness of nurse-led multidisciplinary interventions in primary health care.

METHODS

The following Chinese and English databases were searched for relevant articles: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang and Chinese Biomedical Literature Database (CBM), from the establishment of the databases until the last updating search 1 April 2022. Two researchers screened the studies independently and extracted the data. Meta-analysis was performed using the RevMan 5.3 software.

RESULTS

A total of 12 studies were included in this review. It was found that nurse-led multidisciplinary interventions significantly shortened patients' length of stay in hospital (standardized mean differences [SMD] = -1.28, 95%CI: -2.03 to -0.54; P<0.001) and decreased incidences of complications (RR = 0.24, 95%CI:0.10 to 0.54; P = 0.0006) compared to the control group, and lowered patients' anxiety levels (SMD = -1.21, 95%CI: -1.99 to -0.44; P<0.01) and depression levels (SMD = -1.85, 95%CI: -3.42 to -0.28; P<0.0001). Furthermore, the results of subgroup analysis indicated that nurse-led multidisciplinary interventions had significant effects on patients' self-management ability (SMD = 4.45, 95%CI:2.45 to 6.44; P<0.0001) and quality of life (SMD = 1.01, 95%CI: 0.63 to 1.40; P<0.0001) compared to the control group.

CONCLUSIONS

Nurse-led multidisciplinary interventions had strong effects in primary health care, contributing to shorten patients' length of stay in hospital, decrease incidences of complications and reduce the levels of anxiety and depression. Moreover, nurse-led multidisciplinary interventions also improved patients' self-management ability and quality of life.

摘要

目的

本综述旨在综合现有证据,探讨以护士为主导的多学科干预措施在初级卫生保健中的有效性。

方法

检索以下中英文数据库以获取相关文章:PubMed、Embase、Cochrane图书馆、Web of Science、中国知网(CNKI)、万方和中国生物医学文献数据库(CBM),检索时间从各数据库建库至2022年4月1日最后一次更新检索。两名研究人员独立筛选研究并提取数据。使用RevMan 5.3软件进行荟萃分析。

结果

本综述共纳入12项研究。结果发现,与对照组相比,以护士为主导的多学科干预措施显著缩短了患者的住院时间(标准化均数差[SMD]= -1.28,95%置信区间:-2.03至-0.54;P<0.001),降低了并发症发生率(风险比[RR]= 0.24,95%置信区间:0.10至0.54;P = 0.0006),并降低了患者的焦虑水平(SMD= -1.21,95%置信区间:-1.99至-0.44;P<0.01)和抑郁水平(SMD= -1.85,95%置信区间:-3.42至-0.28;P<0.0001)。此外,亚组分析结果表明,与对照组相比,以护士为主导的多学科干预措施对患者的自我管理能力(SMD= 4.45,95%置信区间:2.45至6.44;P<0.0001)和生活质量(SMD= 1.01,95%置信区间:0.63至1.40;P<0.0001)有显著影响。

结论

以护士为主导的多学科干预措施在初级卫生保健中效果显著,有助于缩短患者住院时间,降低并发症发生率,减轻焦虑和抑郁水平。此外,以护士为主导的多学科干预措施还提高了患者的自我管理能力和生活质量。

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