Objective: To examine the role of community-based nursing interventions in improving outcomes for community-dwelling individuals exhibiting risk factors of cardiovascular disease (CVD).
Design: A systematic review and narrative synthesis.
Data sources: Seven electronic databases (MEDLINE, CINAHL, Global Health, LILACS, Africa-Wide Information, IMEMR, and WPRIM) were searched from inception to 16 March 2018.
Review methods: This review included outcomes from studies that were led by or delivered primarily by nurses for individuals exhibiting risk factors of CVD in community settings. At least two independent reviewers performed study selection, data extraction and risk of bias.
Results: 46 studies met the eligibility criteria. Community nursing interventions were found to be effective in improving clinical outcomes of symptom control, symptom awareness, symptom management, and social outcomes. Effective interventions were found to be facilitated by a community-centric approach, participant empowerment, reinforcement strategies, a targeted approach towards underserved populations, and home visits. These resulted in positive outcomes such as significant reductions in HbA1c for diabetic patients, attainment of blood pressure targets for hypertensive patients and greater improvement in self-reported dietary intake for patients with hyperlipidaemia.
Conclusion: Community-based nurse-led interventions can result in positive outcomes for patients with risk factors of CVD. However, the success of such interventions needs to be facilitated by appropriate funding, thoughtful intervention design and training opportunities for nurses.
Impact: Community-based nursing interventions are largely effective in improving clinical and social outcomes for community-dwelling individuals with risk factors of CVD.
目的: 在于研究社区护理干预对表现出心血管疾病(cardiovascular disease,CVD)危险因素的社区居民预后改善的作用。 设计: 系统综述和叙述合成。 资料来源: 从其建立之初到2018年3月16日,搜索了七大电子数据库(MEDLINE、CINAHL、Global Health、LILACS、Africa-Wide Information、IMEMR和WPRIM)。 综述方法: 该综述包括由护士们主导或主要由护士们提供的研究结果,研究对象是在社区环境中表现出心血管疾病危险因素的患者们。至少有两名独立审查元进行了研究甄选、数据提取和偏倚风险。 结果: 46项研究符合资格标准。经研究发现,社区护理干预在改善症状控制、症状意识、症状管理和社会结果的临床结果方面非常有效。经研究发现,以社区为中心的方法、参与者赋权、强化战略、针对服务不足人群的靶向方法和家访都有助于干预的有效性。这类方法促成了预后的积极性,如糖尿病患者HbA1c显著降低,高血压患者达到 目标血压,高脂血症患者自我报告的饮食摄入有较大改善。 结论:以社区为基础的护士主导型干预可以为表现出心血管疾病危险因素得患者带来积极性结果。然而,这种干预的成功性需要通过适当的资金、深思熟虑的干预设计和护士培训机会来加以促进。 影响: 社区护理干预在改善心血管疾病危险因素类社区居民的临床和社会结果方面非常有效。.
Keywords: cardiovascular diseases; community nursing; home nursing; risk factors; systematic review.
© 2019 John Wiley & Sons Ltd.