Howitt Lyndsay, Jacob Greeshma, Zucal Giulia, Smith Judy, Crocker Ellacott Rhonda, Sharkey Shirlee
Registered Nurses' Association of Ontario, 500-4211 Yonge Street, Toronto, ON M2P 2A9, Canada.
Independent Researcher, Newmarket, ON L3Y 7T1, Canada.
Healthcare (Basel). 2024 Sep 10;12(18):1814. doi: 10.3390/healthcare12181814.
Persons with complex care needs that arise due to chronic health conditions, serious illness, or social vulnerability are at increased risk of adverse health outcomes during transitions in care. To inform the development of a best practice guideline, a systematic review was conducted to examine the effect that navigation support has during transitions in care on quality of life, emergency department visits, follow-up visits, patient satisfaction, and readmission rates for persons with complex care needs. Eight databases were searched from 2016 to 2023. Studies were appraised using validated tools and data were extracted and presented narratively. The GRADE approach was used to assess the certainty of the evidence. Seventeen studies were included and the majority focused on transitions from hospital to home. Navigation support was provided for one month to one year following a transition. Results weakly indicate that providing navigation support during transitions in care may increase follow-up visits, reduce readmissions within 30 days, and increase patient satisfaction for persons with complex care needs. There were no important differences for quality of life and emergency department visits within 30 days of a transition. The certainty of the evidence was very low. Providing navigation support during transitions in care may improve outcomes for persons with complex needs; however, there remains uncertainty regarding the effectiveness of this intervention and more high-quality research is needed.
由于慢性健康状况、重病或社会脆弱性而产生复杂护理需求的人群，在护理过渡期间出现不良健康结果的风险增加。为了为最佳实践指南的制定提供信息，我们进行了一项系统综述，以研究导航支持在护理过渡期间对有复杂护理需求人群的生活质量、急诊就诊、随访就诊、患者满意度和再入院率的影响。我们检索了2016年至2023年的八个数据库。使用经过验证的工具对研究进行评估，并提取数据并进行叙述性呈现。采用GRADE方法评估证据的确定性。纳入了17项研究，大多数研究关注从医院到家庭的过渡。在过渡后的一个月至一年内提供导航支持。结果微弱地表明，在护理过渡期间提供导航支持可能会增加随访就诊次数，减少30天内的再入院率，并提高有复杂护理需求人群的患者满意度。在过渡后30天内，生活质量和急诊就诊次数没有显著差异。证据的确定性非常低。在护理过渡期间提供导航支持可能会改善有复杂需求人群的结局；然而，这种干预措施的有效性仍存在不确定性，需要更多高质量的研究。
