背景:护士在全身性自身免疫性风湿性疾病患者的治疗中起着重要作用。关于护士主导的干预措施对该人群患者报告结果的有效性知之甚少。这项系统评价的目的是检查护士主导的系统性自身免疫性风湿性疾病干预的证据。
方法:使用系统评价和荟萃分析指南的首选报告项目,在PubMed进行了全面的文献检索,护理和相关健康文献的累积指数,PsycINFO,和Embase从数据库开始到2022年9月发表的研究。如果这些研究以英文发表在同行评审的期刊上,并使用随机对照试验设计评估了护士主导的干预措施在患有全身性自身免疫性风湿性疾病的成年人中的有效性。筛选,全文回顾,和质量评估由两名独立审核员进行。
结果:总共有162篇文章被确定为可能包括在内,其中包括五项研究。五项研究中有四项(80%)是在系统性红斑狼疮中进行的。护士主导的干预措施类型存在显着差异;大多数包括护士的教育课程和后续咨询(n=4)。最常见的患者报告的结果是健康相关的生活质量(n=3),疲劳(n=3),心理健康(包括焦虑和抑郁)(n=2),和自我效能感(n=2)。干预的持续时间从12周到6个月不等。所有研究都包括一名受过专业培训和教育的护士,并显示其主要结果显着改善。大多数研究(60%)被认为是高方法学质量。
结论:本系统综述为在系统性自身免疫性风湿性疾病中使用护士主导的干预措施提供了新的证据。我们的发现强调了护士在提供非药物策略以帮助患者更好地管理疾病和改善健康结果方面的重要作用。
BACKGROUND: Nurses play an important role in the management of patients with systemic autoimmune rheumatic diseases. Little is known about the effectiveness of nurse-led interventions on patient-reported outcomes in this population. The aim of this systematic
review was to examine the evidence of nurse-led interventions in systemic autoimmune rheumatic diseases.
METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a comprehensive literature search was conducted in PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and Embase for studies published from database inception to September 2022. Studies were included if they were published in a peer-reviewed journal in English and evaluated the effectiveness of a nurse-led intervention using a randomized controlled trial design in adults with a systemic autoimmune rheumatic disease. Screening, full-text
review, and quality appraisal were conducted by two independent reviewers.
RESULTS: A total of 162 articles were identified for possible inclusion, of which five studies were included. Four of five studies (80%) were conducted in systemic lupus erythematosus. There was significant variability in the types of nurse-led interventions; the majority included educational sessions and follow up counseling by a nurse (n = 4). The most common patient-reported outcomes were health-related quality of life (n = 3), fatigue (n = 3), mental health (including anxiety and depression) (n = 2), and self-efficacy (n = 2). The duration of the interventions varied from 12 weeks to 6 months. All studies included a nurse with specialized training and education and showed significant improvements in their primary outcomes. The majority of the studies (60%) were considered high methodological quality.
CONCLUSIONS: This systematic
review provides emerging evidence for the use of nurse-led interventions in systemic autoimmune rheumatic diseases. Our findings emphasize the important role of nurses in providing nonpharmacological strategies to help patients better manage their disease and improve health outcomes.