Systematic Review of Dyadic Interventions for Ambulatory Care Sensitive Conditions: Current Evidence and Key Gaps.

IF 2.4 3区 医学 Q3 GERIATRICS & GERONTOLOGY
Clinical Gerontologist Pub Date : 2025-07-01 Epub Date: 2022-06-17 DOI:10.1080/07317115.2022.2086089
Jennalee S Wooldridge, Fernanda S Rossi, Coral Anderson, Natalie M Yarish, Ambri Pukhraj, Ranak B Trivedi
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引用次数: 0

Abstract

Objectives: Identify non-pharmacological interventions to support patient/caregiver dyads with ACSCs; review the effects of dyadic interventions on health services outcomes; and review the effectiveness of dyadic interventions on patient and caregiver biopsychosocial outcomes.

Methods: A systematic review of randomized controlled trials (RCTs).

Results: Twenty-six manuscripts representing 20 unique RCTs (Mean N = 154 patients, 140 caregivers) were eligible. Eleven RCTs examined caregiving in patients with HF, seven with T2DM, one with COPD, and one with mixed ACSCs. Dyadic interventions for ACSCs were diverse in terms of length and content, with most including an educational component. Only 4/26 included studies had a low risk of bias. Interventions were most successful at improving quality of life, clinical health outcomes, health behaviors, and health services outcomes, with fewer improvements in patient mental health outcomes, psychosocial outcomes, relationship outcomes, and caregiver outcomes in general. The largest effect sizes were reported from trials focused on T2DM.

Conclusions: High-quality research with consistent measuring instruments is needed to understand which interventions are associated with improved patient and caregiver outcomes.

Clinical implications: There may be clinically relevant benefits to including caregivers in interventions for patients with ACSCs, and clinicians should consider this when devising treatment plans.

对门诊护理敏感条件的二元干预的系统评价:当前的证据和关键差距。
目的:确定支持ACSCs患者/护理人员的非药物干预措施;审查双重干预措施对保健服务结果的影响;并回顾二元干预对患者和护理者生物心理社会结果的有效性。方法对随机对照试验(rct)进行系统评价。结果纳入20项独特的随机对照试验(平均N = 154例患者,140名护理人员),共26篇论文。11项随机对照试验检查了HF患者、7例T2DM患者、1例COPD患者和1例混合ACSCs患者的护理情况。acsc的二元干预措施在长度和内容方面各不相同,其中大多数包括教育成分。只有4/26纳入的研究具有低偏倚风险。干预措施在改善生活质量、临床健康结果、健康行为和健康服务结果方面最为成功,而在患者精神健康结果、社会心理结果、关系结果和一般护理结果方面的改善较少。最大的效应量来自于T2DM的试验。结论需要高质量的研究和一致的测量工具来了解哪些干预措施与改善患者和护理人员的预后有关。临床意义将护理人员纳入ACSCs患者的干预可能具有临床相关的益处,临床医生在制定治疗计划时应考虑到这一点。
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来源期刊
Clinical Gerontologist
Clinical Gerontologist GERIATRICS & GERONTOLOGY-PSYCHIATRY
CiteScore
6.20
自引率
25.00%
发文量
90
审稿时长
>12 weeks
期刊介绍: Clinical Gerontologist presents original research, reviews, and clinical comments relevant to the needs of behavioral health professionals and all practitioners who work with older adults. Published in cooperation with Psychologists in Long Term Care, the journal is designed for psychologists, physicians, nurses, social workers, counselors (family, pastoral, and vocational), and other health professionals who address behavioral health concerns found in later life, including: -adjustments to changing roles- issues related to diversity and aging- family caregiving- spirituality- cognitive and psychosocial assessment- depression, anxiety, and PTSD- Alzheimer’s disease and other neurocognitive disorders- long term care- behavioral medicine in aging- rehabilitation and education for older adults. Each issue provides insightful articles on current topics. Submissions are peer reviewed by content experts and selected for both scholarship and relevance to the practitioner to ensure that the articles are among the best in the field. Authors report original research and conceptual reviews. A unique column in Clinical Gerontologist is “Clinical Comments." This section features brief observations and specific suggestions from practitioners which avoid elaborate research designs or long reference lists. This section is a unique opportunity for you to learn about the valuable clinical work of your peers in a short, concise format.
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