The role of community-based nursing interventions in improving outcomes for individuals with cardiovascular disease: A systematic review

Emeline Han; Rina Yu Chin Quek; See Mieng Tan; Shweta R Singh; Farah Shiraz; Montserrat Gea-Sánchez; Helena Legido-Quigley

doi:10.1016/j.ijnurstu.2019.103415

The role of community-based nursing interventions in improving outcomes for individuals with cardiovascular disease: A systematic review

Int J Nurs Stud. 2019 Dec:100:103415. doi: 10.1016/j.ijnurstu.2019.103415. Epub 2019 Aug 30.

Authors

Emeline Han¹, Rina Yu Chin Quek¹, See Mieng Tan¹, Shweta R Singh¹, Farah Shiraz¹, Montserrat Gea-Sánchez², Helena Legido-Quigley³

Affiliations

¹ Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03, Tahir Foundation Building, Singapore 117549, Singapore.
² GESEC Group, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Montserrat Roig, 25198 Lleida, Spain; Healthcare Research Group (GRECS), Institute of Biomedical Research in Lleida (IRBLleida), Av. Alcalde Rovira Roure, 80, 25198 Lleida, Spain. Electronic address: montse.gea@dif.udl.cat.
³ Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03, Tahir Foundation Building, Singapore 117549, Singapore; GESEC Group, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Montserrat Roig, 25198 Lleida, Spain.

PMID: 31670215
DOI: 10.1016/j.ijnurstu.2019.103415

Abstract

Objective: To examine the role of community-based nursing interventions in improving outcomes for community-dwelling individuals with cardiovascular disease.

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 without language restrictions.

Review methods: We included studies evaluating the outcomes of interventions led by, or primarily delivered by, nurses for individuals with cardiovascular disease in community settings. Study selection, data extraction and risk of bias assessments were performed by at least two independent reviewers.

Results: Twenty-eight studies met the inclusion criteria and were included in this review. Community-based nursing interventions improved outcomes in four key areas: (1) self-care, (2) health, (3) healthcare utilisation, and (4) quality of care. Significant improvements were reported in patients' knowledge and ability to self-manage, severity of disease, functional status, quality of life, risk of death, hospital readmission days, emergency department visits, healthcare costs and satisfaction with care. Facilitators to intervention effectiveness included the use of an individualised approach, multidisciplinary approach, specially trained nurses, family involvement and the home setting. Conversely, barriers to intervention success included limitations in nurses' time and skills, ineffective interdisciplinary collaboration and insufficient intervention intensity.

Conclusions: The overall evidence is positive regarding the role of community-based nursing interventions in improving outcomes for individuals with cardiovascular disease. However, this review highlights the need for more robust research establishing definitive relationships between different types of interventions and outcomes as well as evaluating the cost-effectiveness of these interventions to aid the development of sustainable policy solutions.

Keywords: Cardiovascular diseases; Community health nursing; Home health nursing; Systematic review.

Publication types

Systematic Review

MeSH terms

Cardiovascular Diseases / nursing*
Community Health Nursing / organization & administration*
Humans
Treatment Outcome