Self-management interventions to improve health outcomes in youth living with congenital heart disease: A Systematic Review and Narrative Synthesis.

Ricardo J Loor-Torres, Maria B Mateo Chavez, Kasey Boehmer, Laura Suarez Pardo, Heidi M Connolly, Alexander C Egbe, Kelli Passalacqua, Angela M Kosec, Luke J Burchill
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Abstract

Aims: Congenital heart disease (CHD) presents lifelong challenges that require effective self-management skills, particularly for youth transitioning to adulthood. This systematic review evaluates the impact of self-management interventions, grounded in self-efficacy, on both health and patient-reported outcomes in youths with CHD.

Methods and results: Adhering to PRISMA guidelines, we conducted a systematic review and registered the protocol in PROSPERO. We included interventional studies targeting youth aged 15-24 years with CHD that employed self-management interventions based on self-efficacy. Comprehensive searches were performed in Ovid MEDLINE, Ovid EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and Scopus from January 1973 to March 2024, with an update to include studies published until December 2024. Two reviewers independently screened titles, abstracts, and full texts, resolving disagreements by consensus. Data extraction followed TIDieR guidelines, and risk of bias was assessed using the Cochrane ROBINS-I and RoB 2 tools. Out of 54 potential studies, 4 met the eligibility criteria, representing 150 patients aged 16-19 years. The studies reported improvements in condition-related knowledge, self-management skills, and social support, although data on clinical health outcomes were limited. A narrative synthesis of the selected interventions was performed.

Conclusion: Self-management interventions using self-efficacy frameworks show promise for improving patient-reported outcomes among youth with CHD. However, there is a scarcity of data on their impact on health outcomes. Further research is needed to develop and implement interventions tailored to this population, potentially improving both self-management and clinical outcomes.

Registration: CRD42024499008.

自我管理干预改善青少年先天性心脏病患者的健康结果:系统综述和叙事综合
目的:先天性心脏病(CHD)是终身的挑战,需要有效的自我管理技能,特别是对于过渡到成年期的年轻人。本系统综述以自我效能为基础,评估自我管理干预对青少年冠心病患者健康和患者报告结果的影响。方法和结果:遵循PRISMA指南,我们进行了系统评价并在PROSPERO注册了该方案。我们纳入了针对15-24岁冠心病青年的干预研究,这些研究采用基于自我效能的自我管理干预。从1973年1月到2024年3月,在Ovid MEDLINE、Ovid EMBASE、CINAHL、Cochrane中央对照试验注册库、Cochrane系统评价数据库和Scopus中进行了全面的检索,并更新了到2024年12月发表的研究。两位审稿人独立筛选标题、摘要和全文,通过协商一致解决分歧。数据提取遵循TIDieR指南,使用Cochrane ROBINS-I和rob2工具评估偏倚风险。在54项潜在研究中,4项符合资格标准,代表150名16-19岁的患者。这些研究报告了病情相关知识、自我管理技能和社会支持的改善,尽管临床健康结果的数据有限。对选定的干预措施进行叙事综合。结论:使用自我效能框架的自我管理干预有望改善青少年冠心病患者报告的结果。然而,缺乏关于它们对健康结果影响的数据。需要进一步的研究来开发和实施针对这一人群的干预措施,以潜在地改善自我管理和临床结果。注册:CRD42024499008。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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