Joana Portela, Graça Melo, Tânia Mendes, Helga Rafael Henriques
{"title":"The effect of nurse-led interventions in self-efficacy and psychosocial adjustment of individuals with bowel ostomy: a systematic review.","authors":"Joana Portela, Graça Melo, Tânia Mendes, Helga Rafael Henriques","doi":"10.1177/17449871261462845","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Bowel ostomies pose major physical and psychosocial challenges. Self-efficacy supports ostomy self-care, and nurses play a central role through education, training and ongoing support.</p><p><strong>Aim: </strong>To synthesise evidence on nurse-led interventions that enhance self-efficacy and psychosocial adjustment in adults with bowel ostomy and to identify intervention components and delivery characteristics.</p><p><strong>Methods: </strong>A systematic review followed the Joanna Briggs Institute (JBI) methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Searches were undertaken in five databases (CINAHL, PubMed, Scopus, Web of Science and Cochrane Library) and grey literature (December 2024). Two reviewers independently extracted and appraised data using JBI tools, with results narratively synthesised.</p><p><strong>Results: </strong>Fourteen studies were included. Nurse-led, multicomponent interventions combining education, training, follow-up and psychosocial support were most effective. Hybrid delivery and post-discharge follow-up strengthened outcomes. Most programmes were unidisciplinary, whereas multidisciplinary approaches provided broader psychosocial benefits. Heterogeneity across studies limited quantitative synthesis.</p><p><strong>Conclusion: </strong>Nurse-led, multicomponent interventions enhance self-efficacy and psychosocial adjustment, particularly when hybrid, sustained and informed by the theoretical domains framework (TDF). However, the evidence is limited by small sample sizes, heterogeneity of interventions and risk of bias in some studies. Policies should embed these interventions into standard care, emphasising continuity and digital inclusion.</p>","PeriodicalId":47172,"journal":{"name":"Journal of Research in Nursing","volume":" ","pages":"17449871261462845"},"PeriodicalIF":2.1000,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498689/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Research in Nursing","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/17449871261462845","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Bowel ostomies pose major physical and psychosocial challenges. Self-efficacy supports ostomy self-care, and nurses play a central role through education, training and ongoing support.
Aim: To synthesise evidence on nurse-led interventions that enhance self-efficacy and psychosocial adjustment in adults with bowel ostomy and to identify intervention components and delivery characteristics.
Methods: A systematic review followed the Joanna Briggs Institute (JBI) methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Searches were undertaken in five databases (CINAHL, PubMed, Scopus, Web of Science and Cochrane Library) and grey literature (December 2024). Two reviewers independently extracted and appraised data using JBI tools, with results narratively synthesised.
Results: Fourteen studies were included. Nurse-led, multicomponent interventions combining education, training, follow-up and psychosocial support were most effective. Hybrid delivery and post-discharge follow-up strengthened outcomes. Most programmes were unidisciplinary, whereas multidisciplinary approaches provided broader psychosocial benefits. Heterogeneity across studies limited quantitative synthesis.
Conclusion: Nurse-led, multicomponent interventions enhance self-efficacy and psychosocial adjustment, particularly when hybrid, sustained and informed by the theoretical domains framework (TDF). However, the evidence is limited by small sample sizes, heterogeneity of interventions and risk of bias in some studies. Policies should embed these interventions into standard care, emphasising continuity and digital inclusion.
背景：肠造口术带来了重大的生理和心理挑战。自我效能支持造口术自我护理，护士通过教育、培训和持续支持发挥核心作用。目的：综合证据，护士主导的干预措施，提高自我效能感和心理社会适应的成人肠造口，并确定干预的组成部分和交付特点。方法：系统评价遵循乔安娜布里格斯研究所（JBI）的方法和系统评价和荟萃分析（PRISMA） 2020指南的首选报告项目。检索五个数据库（CINAHL、PubMed、Scopus、Web of Science和Cochrane Library）和灰色文献（2024年12月）。两名审稿人使用JBI工具独立提取和评估数据，并对结果进行叙述性综合。结果：纳入14项研究。以护士为主导，结合教育、培训、随访和社会心理支持的多成分干预措施最为有效。混合分娩和出院后随访加强了结果。大多数方案是跨学科的，而多学科方法提供了更广泛的社会心理效益。研究的异质性限制了定量综合。结论：护士主导的多成分干预可以提高自我效能感和心理社会适应，特别是在混合、持续和由理论领域框架（TDF）提供信息的情况下。然而，证据受到样本量小、干预措施异质性和某些研究偏倚风险的限制。政策应将这些干预措施纳入标准护理，强调连续性和数字包容。
期刊介绍：
The Journal of Research in Nursing is a leading peer reviewed journal that blends good research with contemporary debates about policy and practice. The Journal of Research in Nursing contributes knowledge to nursing practice, research and local, national and international health and social care policy. Each issue contains a variety of papers and review commentaries within a specific theme. The editors are advised and supported by a board of key academics, practitioners and policy makers of international standing. The Journal of Research in Nursing will: • Ensure an evidence base to your practice and policy development • Inform your research work at an advanced level • Challenge you to critically reflect on the interface between practice, policy and research
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
