Lucillie Silahis Sturm, Sarah Yeun-Sim Jeong, Michelle Giles
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引用次数: 0
Abstract
Aims: To determine the effectiveness of nurse-led/involved home-based interventions for older people with COPD and to explore the experiences of older people and nurses with the interventions.
Design: A mixed-methods systematic review following the JBI methodology for mixed-methods systematic reviews.
Data sources: The search included relevant and peer-reviewed studies published from January 2010 to December 2023 in CINAHL, MEDLINE, Cochrane Central Register of Controlled Trials, PsycINFO, EMBASE, JBI, EMCARE and ProQuest.
Review methods: English-language reports of nurse-led/involved home-based interventions for people with COPD were included based on authors' consensus. Three reviewers performed independent quality appraisal using JBI tools. A convergent segregated approach was used for data synthesis and integration.
Results: Seven interventions were identified in two mixed-methods, two qualitative, two quasi-experimental studies, and one secondary analysis from a randomised control trial. The effectiveness of the interventions was measured with various outcomes and was effective to some extent, with reduced hospitalisation, hospitalisation days, hospitalisation cost and all-paid claims. However, the outcomes were not statistically significant, and the effectiveness was inconclusive. While patients appreciated support and resources, some perceived them as a double-edged sword.
Conclusions: Patients preferred more holistic interventions over extended periods. The inconclusive findings and limitations warrant further research with larger sample sizes and comparable measurement tools and outcomes.
Impact: This is the first mixed-methods systematic review on the effectiveness of home interventions for people with COPD with a clear definition of 'nurse-led'. Nurses felt highly valued by patients and other health professionals; however, they reported a lack of support from management. The lack of interventions led by nurses challenges them to lead, deliver and evaluate what matters to people with COPD.
Reporting method: This systematic review was reported in accordance with the Referred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
目的：确定护士主导/参与的家庭干预对老年COPD患者的有效性，并探讨老年人和护士参与干预的经验。设计：采用JBI方法进行混合方法系统评价。数据来源：检索包括2010年1月至2023年12月在CINAHL、MEDLINE、Cochrane Central Register of Controlled Trials、PsycINFO、EMBASE、JBI、EMCARE和ProQuest上发表的相关和同行评议的研究。回顾方法：基于作者的共识，纳入了护士主导/参与的COPD患者家庭干预的英文报告。三位审稿人使用JBI工具进行独立的质量评估。数据综合和集成采用了收敛隔离方法。结果：在两项混合方法、两项定性研究、两项准实验研究和一项随机对照试验的二次分析中确定了七种干预措施。干预措施的有效性是通过各种结果来衡量的，并且在一定程度上是有效的，减少了住院时间、住院天数、住院费用和全付索赔。然而，结果无统计学意义，有效性尚无定论。虽然患者很感激支持和资源，但有些人认为这是一把双刃剑。结论：患者更倾向于长期的整体干预。不确定的发现和局限性值得进一步研究更大的样本量和可比较的测量工具和结果。影响：这是首次对COPD患者家庭干预有效性进行的混合方法系统评价，并明确定义了“护士主导”。护士感到受到病人和其他卫生专业人员的高度重视；然而，他们报告说缺乏管理层的支持。由于缺乏由护士主导的干预措施，她们很难领导、提供和评估对慢性阻塞性肺病患者至关重要的事情。报告方法：本系统评价按照系统评价和荟萃分析（PRISMA）指南的参考报告项目进行报告。患者或公众捐款：不适用。
期刊介绍：
The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice.
JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice.
We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.
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