The effectiveness of nursing interventions to improve self-care for patients with heart failure at home: a systematic review and meta-analysis
Notice bibliographique
Résumé
Abstract Background Self-care plays an important role in the treatment of patients with heart failure (HF) and adequately performed self-care at home can contribute to fewer hospitalizations, lower mortality risk and require less emergency care. The aim of this systematic review and meta-analysis was to synthesise evidence on the effectiveness of nursing interventions on HF-related self-care at home. Methods Medline, Scopus, Cumulative Index to Nursing and Allied Health Literature, Cochrane database, Web of Science, PsycInfo, and trial registers were searched up to 31st December 2022. We aimed to include experimental and observational studies with a control group investigating nursing interventions including transitional care, home care programs, phone calls, digital interventions, or a combination thereof on self-care of patients with HF. Outcomes were self-care maintenance, self-care management, and self-care behaviours, measured with various instruments. The screening and data extraction were performed independently by two reviewers, and disagreements were solved by a third reviewer. Cochrane risk of bias tool for randomised trials and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach were used. Results Twenty-seven studies were included (2176 participants), of which 24 were randomised controlled trials. Three categories of interventions emerged, called “transitional care”, “home care”, and “remote interventions”. Transitional care aimed at caring for patients at their homes after discharge through phone calls, digital interventions, and home visits may result in little to no difference in self-care maintenance (MD 7.26, 95% CI 5.20, 9.33) and self-care management (MD 5.02, 95% CI 1.34, 8.69) while contrasting results emerged in self-care behaviours since two out of six studies reported no improvements in self-care. Home care combined with phone calls or digital interventions likely increase self-management and self-care behaviours (MD -7.91, 95% CI -9.29, -6.54). Remote care could improve self-care behaviours when delivered as phone call programs, but they are ineffective on all outcomes when delivered as digital interventions alone. Conclusion Transitional care and home care combined with phone calls and digital interventions, and phone calls caring for patients at their home could slightly improve self-care in patients with HF. However, more research is needed to study the effects across different domains of self-care and of interventions delivered through digital interventions alone.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,018 | 0,040 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,029 | 0,046 |
| Bibliométrie | 0,010 | 0,008 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,003 |
| Science ouverte | 0,003 | 0,002 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».