Aims: To analyse the effects of nurse-driven self-management (SM) programs on physical and psychosocial health variables in people with chronic obstructive pulmonary disease (COPD).
Design: A systematic review and meta-analysis.
Data sources: An exhaustive scanning of PubMed, Cochrane Controlled Register of Trials, CINAHL, ScienceDirect and Medline databases between January 2010-December 2019 was conducted for this meta-analysis.
Review methods: Randomized controlled trials (RCTs) related to nurse-driven SM programs in COPD population were included. The standardized mean differences with 95% confidence intervals were determined for the main variables and heterogeneity was analysed using the I2 test. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used.
Results: Twelve studies were included. The results indicated that significant difference in physical health scores based on COPD Assessment Tool (CAT) and walking distance according to the 6-min walk distance (6MWD) test in the intervention groups compared with the control groups. About psychosocial health findings, the quality of life increased and the Hospital Anxiety and Depression Scale (HADS) scores decreased following SM programs. All of the studies had good quality (varying from 5-8 points) according to The Modified Jadad Scale.
Conclusion: Nurse-driven SM programs may contribute to prognosis in patients with COPD. Due to methodological weaknesses in the included trials, high-quality RCTs are needed to better determine the effects of nurse-driven SM programs in the management of COPD. Nurse-driven SM programs may be employed as a useful strategy to improve health status and QOL and psychosocial health in the COPD population, as well.
Impact: Current evidence shows that nurse-driven SM programs could be safely integrated into the clinical practice for patients with COPD. Future studies are warranted that evaluating the effects of nurse-driven SM programs on other frequently observed COPD symptoms such as dyspnoea, fatigue and sleep disturbance.
目标: 分析护士驱动的自我管理计划对慢性阻塞性肺疾病(COPD)患者身心健康变量的影响。 设计: 系统回顾和荟萃分析。 数据来源: 对国际文献数据库(PubMed)、Cochrane 临床对照试验中心注册数据库、护理学数据库(CINAHL)、期刊全文数据库(ScienceDirect)和联机医学文献分析和检索系统(MEDLINE)数据库2010年1月至2019年12月期间的文章进行详尽的扫描。 评审方法: 纳入慢性阻塞性肺病患者群体中与护士驱动的自我管理计划相关的随机对照试验(RCT)。确定主要变量的标准化平均差(95%置信区间),并用I2检验分析异质性。应用系统回顾和荟萃分析的首选报告项目(PRISMA)。 结果: 纳入12篇研究。结果表明,干预组与对照组相比,慢性阻塞性肺病患者评定工具(CAT)的身体健康评分和6分钟步行距离(6MWD)测试存在显著差异。 心理社会健康调查结果显示,经过自我管理计划,生活质量提高,医院焦虑和抑郁量表(HADS)得分下降。根据改良的Jadad评分法,所有研究均质量良好(从5-8分不等)。 结论: 护士驱动的自我管理计划可能有助于慢性阻塞性肺病患者的预后。由于纳入试验的方法学的缺陷,需要高质量的随机对照试验来更好地确定护士驱动的自我管理计划在慢性阻塞性肺病管理中的效果。护士驱动的自我管理计划可以作为改善慢性阻塞性肺病群体的健康状况、生活质量和心理社会健康的有效策略。 影响: 目前的证据表明,护士驱动的自我管理计划可以安全地整合到慢性阻塞性肺病患者的临床实践中。未来的研究有必要评估护士驱动的自我管理计划对其他常见慢性阻塞性肺病症状(如呼吸困难、疲劳和睡眠障碍)的影响。.
Keywords: meta-analysis; nurse; nursing; pulmonary disease; self-care; self-management.
© 2020 John Wiley & Sons Ltd.