Sun Binbin, Wang Jianhui, Dong Jianxiu, Qin Lu, Xu Yuexuan, Tian Beibei
J Cardiovasc Nurs. 2025;40(1):39-54. doi: 10.1097/JCN.0000000000001083. Epub 2024 Feb 12.
Health education is important for self-care in patients with heart failure. However, the evidence for the effect of distance education as an intervention to deliver instruction for patients after discharge through digital devices on self-care is limited.
In this study, our aim was to explore the effect of distance education on self-care in patients with heart failure.
We searched 11 electronic databases and 3 trial registries for randomized controlled trials with low risk of bias and high-quality evidence to compare the effect of usual and distance education on self-care. Quality appraisal was performed using the Cochrane Risk of Bias Tool. Using the Review Manager 5.4 tool, a meta-analysis was conducted. Certainty of the evidence was rated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).
Fifteen articles were eligible for this study. Compared with usual education, distance education improved self-care maintenance (mean difference [MD], 6.62; 95% confidence interval [CI], 3.93-9.31; GRADE, moderate quality), self-care management (MD, 5.10; 95% CI, 3.25-6.95; GRADE, high quality), self-care confidence (MD, 6.66; 95% CI, 4.82-8.49; GRADE, high quality), heart failure knowledge (MD, 0.78; 95% CI, 0.01-1.56; GRADE, moderate quality), and quality of life (MD, -5.35; 95% CI, -8.73 to -1.97; GRADE, moderate quality). Subgroup analysis revealed distance education was more effective than usual education in self-care when the intervention was conducted for 1 to 6 months, more than 3 times per month, and a single intervention lasting more than 30 minutes.
This review shows the benefits of distance education on self-care, heart failure knowledge, and quality of life of patients with heart failure. The intervention duration, frequency, and duration of a single intervention could have affected the intervention effect.
健康教育对心力衰竭患者的自我护理很重要。然而，关于通过数字设备对出院患者进行远程教育作为一种干预措施来提供指导对自我护理效果的证据有限。
在本研究中，我们的目的是探讨远程教育对心力衰竭患者自我护理的影响。
我们检索了11个电子数据库和3个试验注册库，以寻找偏倚风险低且证据质量高的随机对照试验，比较常规教育和远程教育对自我护理的影响。使用Cochrane偏倚风险工具进行质量评估。使用Review Manager 5.4工具进行荟萃分析。使用推荐分级、评估、制定和评价（GRADE）对证据的确定性进行评级。
15篇文章符合本研究的条件。与常规教育相比，远程教育改善了自我护理维持（平均差[MD]，6.62；95%置信区间[CI]，3.93 - 9.31；GRADE，中等质量）、自我护理管理（MD，5.10；95% CI，3.25 - 6.95；GRADE，高质量）、自我护理信心（MD，6.66；95% CI，4.82 - 8.49；GRADE，高质量）、心力衰竭知识（MD，0.78；95% CI，0.01 - 1.56；GRADE，中等质量）和生活质量（MD， - 5.35；95% CI， - 8.73至 - 1.97；GRADE，中等质量）。亚组分析显示，当干预持续1至6个月、每月超过3次且单次干预持续超过30分钟时，远程教育在自我护理方面比常规教育更有效。
本综述显示了远程教育对心力衰竭患者自我护理、心力衰竭知识和生活质量的益处。干预持续时间、频率和单次干预持续时间可能影响了干预效果。
