School of Nursing, Jilin University, Changchun, China.
Medical Records Library, The Second Hospital of Jilin University, Changchun, China.
J Clin Nurs. 2024 Apr;33(4):1295-1305. doi: 10.1111/jocn.16956. Epub 2024 Jan 4.
The aim of this study is to evaluate the relative merits of various heart failure models of care with regard to a variety of outcomes.
Systematic review.
Five databases including PubMed, Web of Science, Medline, Embase and Science Direct were searched from the inception date of databases to August 20, 2022.
This review used the Cochrane Collaboration's 'Risk of Bias' tool to assess quality. Only randomised controlled trails were included in this review that assessed all care models in the management of adults with heart failure. A categorical summary of the pattern of the papers was found, followed by extraction of outcome indicators.
Twenty articles (19 studies) were included. Seven examined nurse-led care, two examined multidisciplinary specialist care, nine (10 articles) examined patient self-management, and one examined nurse and physiotherapist co-led care. Regarding outcomes, this review examined how well the four models performed with regard to quality of life, health services use, HF self-care, and anxiety and depression for heart failure patients. The model of patient self-management showed more beneficial results than nurse-led care, multidisciplinary specialist care, and nurse and physiotherapist co-led care in reducing hospital days, improving symptoms, promoting self-care behaviours of HF patients, enhancing the quality of life, and strengthening self-care ability.
This systematic review synthesises the different care models and their relative effectiveness. Four different models of care were summarised. Of these models, the self-management model demonstrated better outcomes.
The self-management model is more effective in increasing self-management behaviours and self-management abilities, lowering the risk of hospitalisation and death, improving quality of life, and relieving anxiety and depression than other models.
There was no funding to remunerate a patient/member of the public for this review.
本研究旨在评估各种心力衰竭护理模式在各种结局方面的相对优势。
系统评价。
从数据库创建日期到 2022 年 8 月 20 日，检索了 5 个数据库，包括 PubMed、Web of Science、Medline、Embase 和 Science Direct。
本综述使用 Cochrane 协作的“偏倚风险”工具评估质量。本综述仅纳入评估成人心力衰竭管理中所有护理模式的随机对照试验。首先找到论文模式的分类摘要，然后提取结果指标。
纳入 20 篇文章（19 项研究）。7 项研究考察了护士主导的护理，2 项研究考察了多学科专家护理，9 项（10 篇文章）考察了患者自我管理，1 项研究考察了护士和物理治疗师联合主导的护理。关于结局，本综述考察了这四种模式在改善心力衰竭患者生活质量、卫生服务利用、心力衰竭自我护理、焦虑和抑郁方面的表现。与护士主导的护理、多学科专家护理和护士和物理治疗师联合主导的护理相比，患者自我管理模式在减少住院天数、改善症状、促进心力衰竭患者自我护理行为、提高生活质量和增强自我护理能力方面显示出更有益的结果。
本系统综述综合了不同的护理模式及其相对效果。总结了四种不同的护理模式。在这些模式中，自我管理模式的效果更好。
与其他模式相比，自我管理模式在增加自我管理行为和自我管理能力、降低住院和死亡风险、提高生活质量以及缓解焦虑和抑郁方面更有效。
本综述没有资金支付患者/公众参与的费用。
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