了解心脏、肺部和重症监护室康复/恢复项目的出勤模式和决定因素：系统回顾和荟萃分析。

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung Pub Date : 2024-09-21 DOI:10.1016/j.hrtlng.2024.09.010

Leanne M. Boehm PhD, RN, ACNS-BC , Kelly Potter PhD, RN , Joanne McPeake PhD, MSc, BN (Hons), RGN , Martin Shaw PhD, MSci , Han Su PhD, RN , Abigail C. Jones MEd, RN , Valerie Renard MSN, AGACNP-BC, CCRN , Tammy L. Eaton PhD, MSc, RN, FNP-BC , Carl Boethel MD , Javed Butler MD, MPH, MBA , Rachel Lane Walden MLIS , Valerie Danesh PhD, RN

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引用次数: 0

摘要

背景：心脏、肺部和重症监护室（ICU）康复/恢复计划是一种健康促进干预措施，旨在改善急性病后的身体恢复、心理健康和生活质量，同时降低不良事件的风险：确定受邀参加心脏康复、肺部康复或重症监护室康复计划的患者出席率的差异以及影响出席率的因素：我们通过检索 PubMed、EMBASE、CINAHL、Web of Science 和手册参考文献列表，对从开始到 2024 年 6 月 3 日的研究进行了系统回顾和荟萃分析。我们纳入了在符合条件的项目中报告急性病住院后患者出勤率的研究。两名团队成员独立筛选文章并提取数据，必要时由第三名成员进行审核并达成共识。我们的主要结果集中在转诊患者中符合条件的项目的就诊率：在筛选出的 3,446 项研究中，有 179 项研究（N = 4,779,012 名患者）纳入了心脏康复（n = 153 项研究）、肺康复（n = 11 项研究）和重症监护室康复（n = 15 项研究）项目。汇总的就诊率分别为：心脏康复项目 53 %（95 % CI：48-57 %），肺康复项目 56 %（95 % CI：42-70 %），重症监护室康复项目 61 %（95 % CI：51-70 %）。参加人数存在显著的异质性（心脏康复 I2=100 %，p < 0.001；肺康复 I2=100 %，p < 0.001；重症监护室康复 I2=94 %，p < 0.01）。就诊障碍包括交通、距离、工作冲突和患者因素（如合并症、年龄较大）。促进因素包括男性、年轻、高学历、收入、医疗服务提供者的建议以及灵活的时间安排。个人因素是影响出勤率的主要因素：结果表明，急性病康复/恢复项目的参加率和影响参加率的因素具有可比性，其中重症监护室恢复项目的平均参加率最高：注册：PROCROPERO CRD42022357261。

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Understanding attendance patterns and determinants in cardiac, pulmonary, and ICU Rehabilitation/Recovery programs: A systematic review and meta-analysis

Background

Cardiac, pulmonary, and intensive care unit (ICU) rehabilitation/recovery programs are health promotion interventions designed to improve physical recovery, psychological well-being, and quality of life after acute illness while reducing the risk of adverse events.

Objective

Identify the difference in attendance rates for patients invited to a cardiac rehabilitation, pulmonary rehabilitation, or ICU recovery program and factors influencing attendance.

Methods

We conducted a systematic review and meta-analysis by searching PubMed, EMBASE, CINAHL, Web of Science, and manual reference lists from inception to June 3, 2024. We included studies reporting patient attendance rates in eligible programs following acute illness hospitalization. Two team members independently screened articles and extracted data, with a third member reviewing and achieving consensus when necessary. Our main outcomes focused on the proportion of attendance in eligible programs among patients referred.

Results

Of 3,446 studies screened, 179 studies (N = 4,779,012 patients) were included across cardiac rehabilitation (n = 153 studies), pulmonary rehabilitation (n = 11 studies), and ICU recovery (n = 15 studies) programs. Pooled attendance rates were 53 % (95 % CI: 48-57 %) for cardiac rehabilitation, 56 % (95 % CI: 42-70 %) for pulmonary rehabilitation, and 61 % (95 % CI: 51-70 %) for ICU recovery programs. Significant attendance heterogeneity was present (cardiac I²=100 %, p < 0.001; pulmonary I²=100 %, p < 0.001; ICU I²=94 %, p < 0.01). Barriers to attendance included transportation, distance, work conflicts, and patient factors (e.g., comorbidities, older age). Facilitators included male gender, younger age, higher education, income, provider recommendations, and flexible scheduling. Individual factors represented the primary domain affecting attendance.

Conclusions

The results indicate comparable attendance rates and factors shaping attendance across acute illness rehabilitation/recovery programs, with ICU recovery programs being the most well-attended on average.

Registration

PROSPERO CRD42022357261

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来源期刊

Heart & Lung 医学-呼吸系统

CiteScore

4.60

自引率

3.60%

发文量

184

审稿时长

35 days

期刊介绍： Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders. The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.