Effectiveness of nursing care intervention on the management of patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis of randomized controlled trials.
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引用次数: 0
Abstract
Background: Chronic obstructive pulmonary disease (COPD) contributes considerably to morbidity and mortality worldwide, necessitating innovative interventions to enhance patient outcomes.
Objectives: The present synthesis aimed to discern the impact of nursing interventions on physical, mental and social health outcomes among COPD patients, focusing on 6-minute walk distance (6MWD), self-efficacy, anxiety, depression, dyspnea, hospitalization, St. George's Respiratory Questionnaire score, patient satisfaction, and all-cause mortality.
Material and methods: This review was conducted to include randomized controlled trials exploring nursing interventions for COPD patients without demographic restriction and sourced from several databases (MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and OpenGrey) until September 2023. Quality assessments were done using the Cochrane Risk of Bias 2 (RoB 2) tool, followed by meta-analysis using a random-effects model with continuous outcomes interpreted as standardized mean difference (SMD) and categorical outcomes as risk ratio (RR).
Results: Thirty-six studies were incorporated, revealing nursing interventions to notably enhance 6MWD (SMD: 0.628, p = 0.001) and self-efficacy (SMD: 0.800, p < 0.001), and significantly decrease anxiety (SMD: -0.952, p = 0.015) and depression levels (SMD: -0.952, p = 0.006). However, the effects of hospitalization, quality of life (QoL) and dyspnea did not reach statistical significance. Notably, high heterogeneity was observed in several outcomes.
Conclusion: Nursing interventions yielded significant improvements for 6MWD, self-efficacy, anxiety, and depression among COPD patients. However, their impact on hospitalization and QoL remains indeterminate, necessitating further nuanced research to optimize and tailor nursing care strategies for this demographic. Enhanced intervention standardization and larger, multicenter trials are warranted to confirm and expand these findings.
背景：慢性阻塞性肺疾病（COPD）在全球范围内造成了相当大的发病率和死亡率，需要创新的干预措施来提高患者的预后。目的：本综合研究旨在了解护理干预对COPD患者身体、心理和社会健康结局的影响，重点关注6分钟步行距离（6MWD）、自我效能感、焦虑、抑郁、呼吸困难、住院、圣乔治呼吸问卷评分、患者满意度和全因死亡率。材料和方法：本综述纳入了从多个数据库（MEDLINE、Cochrane中央对照试验登记册（Central）、Scopus、CINAHL（护理和联合健康文献累积索引）和OpenGrey）获取的无人口统计学限制的COPD患者护理干预的随机对照试验，截止到2023年9月。使用Cochrane风险偏倚2 （RoB 2）工具进行质量评估，随后使用随机效应模型进行meta分析，连续结果解释为标准化平均差（SMD），分类结果解释为风险比（RR）。结果：纳入36项研究，结果显示护理干预显著提高6MWD （SMD: 0.628, p = 0.001）和自我效能感（SMD: 0.800, p < 0.001），显著降低焦虑（SMD: -0.952, p = 0.015）和抑郁水平（SMD: -0.952, p = 0.006）。然而，住院治疗、生活质量（QoL）和呼吸困难的影响均无统计学意义。值得注意的是，在几个结果中观察到高度异质性。结论：护理干预对慢性阻塞性肺病患者的6MWD、自我效能感、焦虑和抑郁有显著改善。然而，它们对住院和生活质量的影响仍然不确定，需要进一步细致的研究来优化和定制针对这一人群的护理策略。有必要加强干预标准化和更大规模的多中心试验来证实和扩展这些发现。
期刊介绍：
Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly.
Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff.
Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj.
Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker.
The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition.
In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus.
Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.
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