Wilson Ryan E, Burton Lindsay, Marini Noah, Loewen Peter, Janke Robert, Aujla Noorat, Davis Dresya, Rush Kathy L
School of Nursing, The University of British Columbia Okanagan, Kelowna, BC, Canada.
Am Heart J Plus. 2024 May 13;43:100404. doi: 10.1016/j.ahjo.2024.100404. eCollection 2024 Jul.
This systematic review evaluates the efficacy of self-care interventions for atrial fibrillation (AF), focusing on strategies for maintenance, monitoring, and management applied individually or in combination. Adhering to the 2020 PRISMA guidelines, the search strategy spanned literature from 2005 to 2023, utilizing keywords and subject headings for "atrial fibrillation" and "self-care" combined with the Boolean operator AND. The databases searched included Medline, Embase, and CINAHL. The initial search, conducted on February 17, 2021, and updated on May 16, 2023, identified 5160 articles, from which 2864 unique titles and abstracts were screened. After abstract screening, 163 articles were reviewed in full text, resulting in 27 articles being selected for data extraction; these studies comprised both observational and randomized controlled trial designs. A key finding in our analysis reveals that self-care interventions, whether singular, dual, or integrated across all three components, resulted in significant improvements across patient-reported, clinical, and healthcare utilization outcomes compared to usual care. Educational interventions, often supported by in-person sessions or telephone follow-ups, emerged as a crucial element of effective AF self-care. Additionally, the integration of mobile and web-based technologies alongside personalized education showed promise in enhancing outcomes, although their full potential remains underexplored. This review highlights the importance of incorporating comprehensive, theory-informed self-care interventions into routine clinical practice and underscores the need for ongoing innovation and the implementation of evidence-based strategies. The integration of education and technology in AF self-care aligns with the recommendations of leading health organizations, advocating for patient-centered, technology-enhanced approaches to meet the evolving needs of the AF population.
本系统评价评估了心房颤动(AF)自我护理干预措施的疗效,重点关注单独或联合应用的维持、监测和管理策略。遵循2020年PRISMA指南,检索策略涵盖了2005年至2023年的文献,使用了“心房颤动”和“自我护理”的关键词和主题词,并结合布尔运算符AND。检索的数据库包括Medline、Embase和CINAHL。2021年2月17日进行了初始检索,并于2023年5月16日更新,共识别出5160篇文章,从中筛选出2864个独特的标题和摘要。经过摘要筛选,对163篇文章进行了全文审查,最终选择27篇文章进行数据提取;这些研究包括观察性和随机对照试验设计。我们分析中的一个关键发现表明,与常规护理相比,自我护理干预措施,无论是单一的、双重的还是涵盖所有三个组成部分的综合措施,在患者报告的、临床的和医疗保健利用结果方面都有显著改善。教育干预措施,通常辅以面对面辅导或电话随访,已成为有效的房颤自我护理的关键要素。此外,将移动和基于网络的技术与个性化教育相结合,在改善结果方面显示出前景,尽管其全部潜力仍未得到充分探索。本综述强调了将全面的、基于理论的自我护理干预措施纳入常规临床实践的重要性,并强调了持续创新和实施循证策略的必要性。房颤自我护理中教育与技术的整合符合领先卫生组织的建议,倡导以患者为中心、技术增强的方法,以满足房颤人群不断变化的需求。