Abstract：
BACKGROUND: With approximately one-third of the global population exhibiting serological evidence of exposure, the hepatitis B virus remains a serious public health threat. Elimination of hepatitis B faces enormous challenges, from prevention to diagnosis, treatment, and long-term monitoring. Nurses are pivotal in optimising the hepatitis B care continuum; however, their contributions have been neglected.
OBJECTIVE: To identify the role of nurses in the elimination of hepatitis B and to synthesise the effectiveness of interventions with nursing roles in approaching the elimination target.
METHODS: A systematic review and meta-analysis.
METHODS: Thirteen databases (EMBASE, MEDLINE via OvidSP, Ovid Emcare, Ovid Nursing Database, British Nursing Index, APA PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, Web of Science Core Collection, China National Knowledge Internet, SinoMed, and Wanfang Data) were searched from their inception to 6 December 2022.
METHODS: Interventional studies examining the contribution of nursing roles towards elimination targets were included. Content analysis was used to extract and map the nursing roles based on the nursing interventions classification system. Random-effects meta-analyses were conducted to examine the effectiveness of the intervention in improving hepatitis B screening, detection, and vaccination rates.
RESULTS: The synthesis from 16 studies identified 13 nursing roles that primarily involved (1) health education and counselling for informed patient decision-making regarding hepatitis B prevention, vaccination, screening, and disease monitoring; (2) case management and health promotion to advocate elimination services at multiple levels and enable equitable access among marginalised communities; and (3) running specialist clinics to lead advanced practices in prescribing and carrying diagnostic tests, formulating evidence-based individualised care plans, and coordinating care throughout the disease process. Interventions with these roles achieved pooled hepatitis B screening and detection rates of 64 % (95 % confidence interval [CI] = 0.44, 0.84) and 2 % (95 % CI = 0.00, 0.05), respectively, increased the odds of hepatitis B virus vaccination by 2.61 times (95 % CI = 1.60, 4.28), improved immunity rate, and enhanced patient adherence to antiviral treatment and monitoring of liver comorbidities. However, their effects on hepatitis B virus DNA-negative conversion rates and hepatocellular carcinoma incidence were not significant.
CONCLUSIONS: Nurses play multifaceted roles in advocating hepatitis B screening and vaccination, initiating outreach efforts in marginalised communities, and leading advanced practices that effectively contribute to the elimination of hepatitis B. Policymakers should consider how nurses may help the achievement of the elimination target.
BACKGROUND: PROSPERO (CRD42022380719) registered on December 12, 2022.
CONCLUSIONS: Nurses raised awareness, initiated outreach efforts, addressed inequalities, and led advanced practices-effectively contributing to eliminating hepatitis B.
OBJECTIVE: To identify the role of nurses in the elimination of hepatitis B and to synthesise the effectiveness of interventions with nursing roles in approaching the elimination target.
METHODS: A systematic review and meta-analysis.
METHODS: Thirteen databases (EMBASE, MEDLINE via OvidSP, Ovid Emcare, Ovid Nursing Database, British Nursing Index, APA PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, Web of Science Core Collection, China National Knowledge Internet, SinoMed, and Wanfang Data) were searched from their inception to 6 December 2022.
METHODS: Interventional studies examining the contribution of nursing roles towards elimination targets were included. Content analysis was used to extract and map the nursing roles based on the nursing interventions classification system. Random-effects meta-analyses were conducted to examine the effectiveness of the intervention in improving hepatitis B screening, detection, and vaccination rates.
RESULTS: The synthesis from 16 studies identified 13 nursing roles that primarily involved (1) health education and counselling for informed patient decision-making regarding hepatitis B prevention, vaccination, screening, and disease monitoring; (2) case management and health promotion to advocate elimination services at multiple levels and enable equitable access among marginalised communities; and (3) running specialist clinics to lead advanced practices in prescribing and carrying diagnostic tests, formulating evidence-based individualised care plans, and coordinating care throughout the disease process. Interventions with these roles achieved pooled hepatitis B screening and detection rates of 64 % (95 % confidence interval [CI] = 0.44, 0.84) and 2 % (95 % CI = 0.00, 0.05), respectively, increased the odds of hepatitis B virus vaccination by 2.61 times (95 % CI = 1.60, 4.28), improved immunity rate, and enhanced patient adherence to antiviral treatment and monitoring of liver comorbidities. However, their effects on hepatitis B virus DNA-negative conversion rates and hepatocellular carcinoma incidence were not significant.
CONCLUSIONS: Nurses play multifaceted roles in advocating hepatitis B screening and vaccination, initiating outreach efforts in marginalised communities, and leading advanced practices that effectively contribute to the elimination of hepatitis B. Policymakers should consider how nurses may help the achievement of the elimination target.
BACKGROUND: PROSPERO (CRD42022380719) registered on December 12, 2022.
CONCLUSIONS: Nurses raised awareness, initiated outreach efforts, addressed inequalities, and led advanced practices-effectively contributing to eliminating hepatitis B.
摘要：
背景：全球约三分之一的人口表现出暴露的血清学证据，乙型肝炎病毒仍然是一个严重的公共健康威胁。消除乙型肝炎面临着巨大的挑战，从预防到诊断，治疗,和长期监测。护士在优化乙型肝炎护理连续性方面至关重要；然而，他们的贡献被忽视了。
目的：确定护士在消除乙型肝炎中的作用，并综合护理干预措施在接近消除目标中的有效性。
方法：系统综述和荟萃分析。
方法：13个数据库(EMBASE，MEDLINE通过OvidSP,OvidEmcare,Ovid护理数据库,英国护理指数，APAPsycINFO,Cochrane中央控制试验登记册,CINAHL,Scopus,WebofScience核心合集,中国全民知识互联网,SinoMed,和万方数据）从成立之初到2022年12月6日进行了搜索。
方法：包括探讨护理角色对消除目标的贡献的介入研究。基于护理干预分类系统，采用内容分析法提取并映射护理角色。进行了随机效应荟萃分析，以检查干预措施在改善乙型肝炎筛查的有效性，检测,和疫苗接种率。
结果：来自16项研究的综合确定了13个护理角色，主要涉及（1）健康教育和咨询关于乙型肝炎预防的知情患者决策，疫苗接种,筛选,和疾病监测；(2)病例管理和健康促进，以倡导多层次的消除服务，并使边缘化社区能够公平获得；(3)开办专科诊所，领导开处方和进行诊断测试的先进做法，制定循证个性化护理计划，并在整个疾病过程中协调护理。这些角色的干预实现了64％的合并乙型肝炎筛查和检出率（95％置信区间[CI]=0.44，0.84）和2％（95％CI=0.00，0.05），分别,乙肝疫苗接种的几率增加了2.61倍（95％CI=1.60，4.28），提高免疫力，并增强患者对抗病毒治疗的依从性和对肝脏合并症的监测。然而,它们对乙型肝炎病毒DNA阴性转换率和肝细胞癌发病率的影响不显著.
结论：护士在倡导乙型肝炎筛查和疫苗接种方面发挥着多方面的作用，在边缘化社区开展外展工作，和领先的先进做法，有效地有助于消除乙型肝炎政策制定者应该考虑如何护士可以帮助实现消除目标。
背景：PROSPERO（CRD42022380719）于2022年12月12日注册。
结论：护士提高了意识，发起外展工作，解决不平等问题，并领导先进的做法-有效地促进消除乙型肝炎
目的：确定护士在消除乙型肝炎中的作用，并综合护理干预措施在接近消除目标中的有效性。
方法：系统综述和荟萃分析。
方法：13个数据库(EMBASE，MEDLINE通过OvidSP,OvidEmcare,Ovid护理数据库,英国护理指数，APAPsycINFO,Cochrane中央控制试验登记册,CINAHL,Scopus,WebofScience核心合集,中国全民知识互联网,SinoMed,和万方数据）从成立之初到2022年12月6日进行了搜索。
方法：包括探讨护理角色对消除目标的贡献的介入研究。基于护理干预分类系统，采用内容分析法提取并映射护理角色。进行了随机效应荟萃分析，以检查干预措施在改善乙型肝炎筛查的有效性，检测,和疫苗接种率。
结果：来自16项研究的综合确定了13个护理角色，主要涉及（1）健康教育和咨询关于乙型肝炎预防的知情患者决策，疫苗接种,筛选,和疾病监测；(2)病例管理和健康促进，以倡导多层次的消除服务，并使边缘化社区能够公平获得；(3)开办专科诊所，领导开处方和进行诊断测试的先进做法，制定循证个性化护理计划，并在整个疾病过程中协调护理。这些角色的干预实现了64％的合并乙型肝炎筛查和检出率（95％置信区间[CI]=0.44，0.84）和2％（95％CI=0.00，0.05），分别,乙肝疫苗接种的几率增加了2.61倍（95％CI=1.60，4.28），提高免疫力，并增强患者对抗病毒治疗的依从性和对肝脏合并症的监测。然而,它们对乙型肝炎病毒DNA阴性转换率和肝细胞癌发病率的影响不显著.
结论：护士在倡导乙型肝炎筛查和疫苗接种方面发挥着多方面的作用，在边缘化社区开展外展工作，和领先的先进做法，有效地有助于消除乙型肝炎政策制定者应该考虑如何护士可以帮助实现消除目标。
背景：PROSPERO（CRD42022380719）于2022年12月12日注册。
结论：护士提高了意识，发起外展工作，解决不平等问题，并领导先进的做法-有效地促进消除乙型肝炎
