腹膜透析患者基于护士的教育干预措施：一项系统评价与荟萃分析。
Nurse-based educational interventions in patients with peritoneal dialysis: A systematic review and meta-analysis.
作者信息
Nopsopon Tanawin, Kantagowit Piyawat, Chumsri Chitsanucha, Towannang Piyaporn, Wechpradit Apinya, Aiyasanon Nipa, Phaichan Ruchdaporn, Kanjanabuch Talerngsak, Pongpirul Krit
机构信息
Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Dialysis Policy & Practice Program (DiP3), School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
出版信息
Int J Nurs Stud Adv. 2022 Sep 24;4:100102. doi: 10.1016/j.ijnsa.2022.100102. eCollection 2022 Dec.
BACKGROUND
Peritoneal dialysis (PD) is a major renal replacement therapy modality for patients with end-stage kidney disease (ESKD) worldwide. As poor self-care of PD patients could lead to serious complications, including peritonitis, exit-site infection, technique failure, and death; several nurse-based educational interventions have been introduced. However, these interventions varied and have been supported by small-scale studies so the effectiveness of nurse-based educational interventions on clinical outcomes of PD patients has been inconclusive.
OBJECTIVES
To evaluate the effectiveness of nurse-based education interventions in PD patients.
DESIGN
A systematic review and meta-analysis of Randomized Controlled Trials (RCTs).
METHODS
We performed a systematic search using PubMed, Embase, and CENTRAL up to December 31, 2021. Selection criteria included Randomized Controlled Trials (RCTs) relevant to nurse-based education interventions in ESKD patients with PD in the English language. The meta-analyses were conducted using a random-effects model to evaluate the summary outcomes of peritonitis, PD-related infection, mortality, transfer to hemodialysis, and quality of life (QoL).
RESULTS
From 9,816 potential studies, 71 theme-related abstracts were selected for further full-text articles screening against eligibility criteria. As a result, eleven studies (1,506 PD patients in seven countries) were included in our systematic review. Of eleven studies, eight studies (1,363 PD patients in five countries) were included in the meta-analysis. Sleep QoL in the intervention group was statistically significantly higher than control (mean difference = 12.76, 95% confidence intervals 5.26-20.27). There was no difference between intervention and control groups on peritonitis, PD-related infection, HD transfer, and overall QoL.
CONCLUSIONS
Nurse-based educational interventions could help reduce some PD complications, of which only the sleep QoL showed statistically significant improvement. High-quality evidence on the nurse-based educational interventions was limited and more RCTs are needed to provide more robust outcomes.
TWEETABLE ABSTRACT
Nurse-based educational interventions showed promising sleep quality improvement and potential peritonitis risk reduction among PD patients.
背景
腹膜透析（PD）是全球终末期肾病（ESKD）患者主要的肾脏替代治疗方式。由于腹膜透析患者自我护理不佳可能导致严重并发症，包括腹膜炎、出口处感染、技术失败和死亡；因此引入了几种以护士为主导的教育干预措施。然而，这些干预措施各不相同，且仅有小规模研究提供支持，所以以护士为主导的教育干预措施对腹膜透析患者临床结局的有效性尚无定论。
目的
评估以护士为主导的教育干预措施对腹膜透析患者的有效性。
设计
对随机对照试验（RCT）进行系统评价和荟萃分析。
方法
截至2021年12月31日，我们使用PubMed、Embase和CENTRAL进行了系统检索。选择标准包括与以护士为主导的ESKD腹膜透析患者教育干预措施相关的英文随机对照试验（RCT）。采用随机效应模型进行荟萃分析，以评估腹膜炎、腹膜透析相关感染、死亡率、转为血液透析和生活质量（QoL）的汇总结果。
结果
从9816项潜在研究中，筛选出71篇主题相关摘要，针对纳入标准进一步筛选全文。结果，11项研究（来自7个国家的1506例腹膜透析患者）纳入我们的系统评价。在这11项研究中，8项研究（来自5个国家的1363例腹膜透析患者）纳入荟萃分析。干预组的睡眠生活质量在统计学上显著高于对照组（平均差异=12.76，95%置信区间5.26 - 20.27）。干预组和对照组在腹膜炎、腹膜透析相关感染、转为血液透析和总体生活质量方面无差异。
结论
以护士为主导的教育干预措施有助于减少一些腹膜透析并发症，其中只有睡眠生活质量有统计学意义的改善。关于以护士为主导的教育干预措施的高质量证据有限，需要更多随机对照试验以提供更有力的结果。
可发推文摘要
以护士为主导的教育干预措施在腹膜透析患者中显示出有改善睡眠质量和降低腹膜炎风险的潜力。
Zotero 插件