Efficacia degli interventi formativi infermieristici nel migliorare i comportamenti di autocura in pazienti affetti da scompenso cardiaco. Risultati di una revisione sistematica e meta-analisi

Translated title of the contribution: [Autom. eng. transl.] Effectiveness of nursing training interventions in improving self-care behaviors in patients with heart failure. Results of a systematic review and meta-analysis

Gianfranco Damiani, Gualtiero Ricciardi, Maria Luisa Rega, Caterina Galletti, Paolo Villari, Carolina Marzuillo, Corrado De Vito

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

[Autom. eng. transl.] INTRODUCTION: Currently heart failure is a significant public health problem, both for its frequency and implications in terms of mortality, morbidity and quality of life, and for the care burden that it entails and, consequently, the related costs. Heart failure is a pathology of the elderly population, for which the hospitalization rate, significantly high, is equal to 1,469 hospitalizations per 100,000 inhabitants, about five times higher than the overall rate, absorbing about 2.6% of all the days of hospitalization provided, both in ordinary and day-hospital settings. Post-discharge education interventions are one of the most effective ways to improve self-care skills and behaviors among patients with heart failure, and ultimately improve prognosis and reduce hospital readmission rates. The goal of this meta-analysis is to summarize the results of the experimental studies that evaluated the efficacy of training interventions led by nurses on self-management among patients with heart failure in terms of improving self-care behavior. MATERIALS AND METHODS: We included randomized controlled trials (RCTs) that evaluated the effectiveness of self-management interventions performed by nurses with any method of communication or training (in person, by phone, email, written, verbal, audiovisual, electronic), on patients aged 18 or over diagnosed with heart failure. Studies were included if patients or relatives maintained the primary role in managing the health condition in the described intervention. Educational interventions in which nurses were involved in medical evaluation or therapy optimization were excluded. The literature search was conducted on Pubmed and on the main electronic search engines (Embase, CINHAL, Scopus and Web of Science). The outcome of interest was the effectiveness of self-management interventions to improve self-care behaviors among patients, measured with appropriate behavioral scales. The measurement times were divided into short term (3 months), medium term (6-9 months) and long term (12 months). For continuous data analysis the standardized mean difference (DMS) was calculated, together with the 95% confidence interval (95% CI), since the same basic concept was measured using different scales. RESULTS: The research allowed the identification of 96 studies, of which eight met the inclusion criteria, for a total of 1,012 participants. Six out of ten participants were male and the average cumulative age at the start of the studies was 69 years (± 10.2). Three out of seven studies (for a total of 442 subjects) reported the most relevant comorbidities which, in order of combined frequency, are: hypertension (54.1%), diabetes (32.8%) and pulmonary diseases (26.5 %). Two studies were conducted in the Netherlands, one in Sweden, one in the USA, one in Colombia, one in Taiwan and one in Iran. The maximum length of follow-up was 12 months for two studies, nine months for two other studies and, finally, four months and three months for one and three studies, respectively. Five studies involving 484 participants assessed self-care skills at 3 months (short term). The standardized mean difference was 0.64 (95% CI 0.19-1.10) in favor of the self-care intervention at 6-9 months (intermediate period). In this case the standardized average difference was 0.45 (95% CI -0.12-1.02). The long-term effect of the training intervention was evaluated by two studies. The largest of which involved 265 participants and the other involved 106 participants. The combined analysis showed a non-statistically significant improvement in the behavior
Translated title of the contribution[Autom. eng. transl.] Effectiveness of nursing training interventions in improving self-care behaviors in patients with heart failure. Results of a systematic review and meta-analysis
Original languageItalian
Title of host publicationATTI del 47° Congresso Nazionale SItI - Poster
Pages928-929
Number of pages2
Publication statusPublished - 2014
Event47° Congresso Nazionale SItI - Riccione
Duration: 1 Oct 20144 Oct 2014

Conference

Conference47° Congresso Nazionale SItI
CityRiccione
Period1/10/144/10/14

Keywords

  • interventi formativi infermieristici
  • scompenso cardiaco

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