BackgroundHeart failure is the most common cause of hospitalization foradults over the age of 65 years. The World Health OrganizationReport on therapeutic patient education recognizes theimportance of patient centered education in the effectivemanagement of chronic diseases. It has been recognized thatadoption of self-management skills by persons with chronicdiseases is necessary to enable them to manage their condition.This meta-analysis evaluates the effectiveness of the nurse-ledself-management interventions to improve self-care behaviorsamong patients.MethodsRelevant major electronic databases were searched frominception to February 2014. All randomized controlled trials(RCTs) that compared nurse led self-management educationwith routine treatment were included in the systematic review.For meta-analyses of continuous data, standardized meandifference (SMD), along with 95% confidence interval (CI),was calculated because the same underlying concept wasmeasured using different outcome measurements.ResultsSeven studies were included in the meta-analysis for a total of942 participants, 493 (52.3%) of which were in the interventiongroup. Four studies involving 406 participants assessedthe self-care abilities at 3 months (short term). The SMD was0.64 (95%CI 0.19–1.10) in favor of the self-managementeducation intervention. Four studies with a total of 707participants reported on self-care abilities at 6-9 months(intermediate term) while the long-term effect of theeducational intervention was assessed by two studies, withnot statistically significant results in both cases (SMD 0.45;95%CI -0.12–1.02 and SMD 0.06; 95%CI -0.15–0.26,respectively).ConclusionsSupportive nursing educational interventions improve the selfcarebehavior in patients with heart failure but only in theshort period. Educational interventions should be reconsideredin a perspective of continuity of care. For this reason aneffective discharge planning is crucial to guarantee continuityin an intermediate care framework.Key message Promoting self-care in chronic patients is necessary toenable them to manage their condition.
Does nurse-led interventions improve self-care behaviors among patients with heart failure? Results of a systematic review and meta-analysis
Galletti, Caterina;
2014-01-01
Abstract
BackgroundHeart failure is the most common cause of hospitalization foradults over the age of 65 years. The World Health OrganizationReport on therapeutic patient education recognizes theimportance of patient centered education in the effectivemanagement of chronic diseases. It has been recognized thatadoption of self-management skills by persons with chronicdiseases is necessary to enable them to manage their condition.This meta-analysis evaluates the effectiveness of the nurse-ledself-management interventions to improve self-care behaviorsamong patients.MethodsRelevant major electronic databases were searched frominception to February 2014. All randomized controlled trials(RCTs) that compared nurse led self-management educationwith routine treatment were included in the systematic review.For meta-analyses of continuous data, standardized meandifference (SMD), along with 95% confidence interval (CI),was calculated because the same underlying concept wasmeasured using different outcome measurements.ResultsSeven studies were included in the meta-analysis for a total of942 participants, 493 (52.3%) of which were in the interventiongroup. Four studies involving 406 participants assessedthe self-care abilities at 3 months (short term). The SMD was0.64 (95%CI 0.19–1.10) in favor of the self-managementeducation intervention. Four studies with a total of 707participants reported on self-care abilities at 6-9 months(intermediate term) while the long-term effect of theeducational intervention was assessed by two studies, withnot statistically significant results in both cases (SMD 0.45;95%CI -0.12–1.02 and SMD 0.06; 95%CI -0.15–0.26,respectively).ConclusionsSupportive nursing educational interventions improve the selfcarebehavior in patients with heart failure but only in theshort period. Educational interventions should be reconsideredin a perspective of continuity of care. For this reason aneffective discharge planning is crucial to guarantee continuityin an intermediate care framework.Key message Promoting self-care in chronic patients is necessary toenable them to manage their condition.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
