临床路径在心脏瓣膜置换术后健康教育中应用效果的Meta分析
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摘要
目的评价临床路径在心脏瓣膜置换术后患者健康教育中的应用效果。方法通过计算机检索Cochrane Library、PubMed、EMBASE、CBM、中国知网(CNKI)、万方数据知识服务平台、中国科技期刊数据库等国内外数据库,检索临床路径在心脏瓣膜置换术后患者健康教育中应用效果的随机对照实验,采用Cochrane协作网提供的RevMan5. 3软件对所提取的资料进行统计分析。结果最终纳入文献7篇,共806例研究对象,Meta分析结果显示:健康教育路径有助于改善心脏瓣膜置换术后患者对健康教育知识掌握的情况(Z=6. 32,P <0. 01)、提高健康教育满意度(Z=4. 55,P <0. 01)、提高治疗依从性(Z=2. 79,P <0. 01)、减少并发症的发生(Z=2. 44,P <0. 05)、缩短ICU治疗时间(Z=7. 30,P <0. 01)。结论临床路径应用于心脏瓣膜置换术后患者健康教育中的效果优于传统健康教育。
Objective To evaluate the application efficacy of clinical pathway in health education for patients after heart-valve Replacement.Methods The randomized control trials of clinical pathway in health education for patients after heart-valve replacement were researched in the databases of Cochrane Library,PubMed,EMBASE,CBM,CNKI,Wan Fang database and VIP.RevMan 5.3 software was used to analyze the extracted data of included studies.Results A total of 7 studies including 806 patients were finally analyzed in this meta-analysis.Meta-analysis showed that the clinical pathway of health education was superior to the traditional health education in following areas,including improving disease-related knowledge( Z = 6.32,P < 0.01)improving patients' satisfaction degree on nursing service( Z = 4.55,P < 0.01) and treatment compliance( Z = 2.79,P < 0.01),reducing the risk of complications( Z = 2.44,P < 0.05) and treatment duration in ICU( Z = 7.30,P < 0.01).Conclusion Compared with the traditional health education,the clinical pathway is more effective in health education for patients after heartvalve replacement.
Objective To evaluate the application efficacy of clinical pathway in health education for patients after heart-valve Replacement.Methods The randomized control trials of clinical pathway in health education for patients after heart-valve replacement were researched in the databases of Cochrane Library,PubMed,EMBASE,CBM,CNKI,Wan Fang database and VIP.RevMan 5.3 software was used to analyze the extracted data of included studies.Results A total of 7 studies including 806 patients were finally analyzed in this meta-analysis.Meta-analysis showed that the clinical pathway of health education was superior to the traditional health education in following areas,including improving disease-related knowledge( Z = 6.32,P < 0.01)improving patients' satisfaction degree on nursing service( Z = 4.55,P < 0.01) and treatment compliance( Z = 2.79,P < 0.01),reducing the risk of complications( Z = 2.44,P < 0.05) and treatment duration in ICU( Z = 7.30,P < 0.01).Conclusion Compared with the traditional health education,the clinical pathway is more effective in health education for patients after heartvalve replacement.
引文
[1]陆洋,傅巧美.心脏瓣膜置换术后患者抗凝治疗依从性的调查分析[J].解放军护理杂志,2016,33(8):62-64.
[2]HAIBO Z,JINZHONG L,YAN L,et al.Low-Intensity International Normalized Ratio(INR)Oral Anticoagulant Therapy in Chinese Patients with Mechanical Heart Valve Prostheses[J].Cell Biochem Biophys,2011,62(1):147-151.
[3]BEZUIDENHOUT D,WILLIAMS D F,ZILLA P.Polymeric heart valves for surgical implantation,catheter-based technologies and heart assist devices[J].Biomaterials,2015,36:6-25.
[4]颜海强,何昌进.心脏瓣膜病治疗的现状与发展[J].福建医药杂志,2014,36(2):140-141.
[5]周保利.临床路径应用指南[M].北京:北京大学医学出版社,2007.
[6]HIGGINS J,GREEN S R.Cochrane handbook for systematic reviews of interventions.4.2.6[J].Naunyn Schmiedebergs Arch Exp Pathol Pharmakol,2009,5(2):S38.
[7]胡雁.循证护理实践:护理学科发展的必然趋势[J].中国护理管理,2013,13(1):3-5.
[8]廖雪芳,杨红英,李燕.应用临床护理路径对心脏瓣膜置换术患者进行健康教育[J].齐鲁护理杂志,2007,13(16):101.
[9]罗玉华,李细森,张亚男,等.临床护理路径在心脏瓣膜置换术后抗凝健康教育中的应用[J].护理实践与研究,2009,6(16):37-39.
[10]刘静兰,刘琼,刘敏,等.健康教育路径对择期瓣膜置换手术患者康复的影响[J].中华现代护理杂志,2011,17(8):917-919.
[11]韦秋萍.心脏瓣膜置换术应用临床护理路径实施健康教育患者需求的调查报告[J].今日健康,2014,13(10):216-216.
[12]吴慧兰,周淑英,龙洪,等.临床护理路径在心脏瓣膜置换术后抗凝健康教育中的应用[J].护理研究,2014,28(10B):3641-3643.
[13]任瑞鲜,雷美兰.心脏瓣膜置换者实施临床路径健康教育的方法与效果[J].内蒙古医科大学学报,2015,37(s2):109-111.
[14]张念彩.临床护理路径在心脏瓣膜置换术后抗凝健康教育中的应用[J].养生保健指南,2016,(30):22.
[15]AAGAARD J,TINGLEFF J,HANSEN C N,et al.Twelve years'clinical experience with the CarboMedics prosthetic heart valve[J].J Heart Valve Dis,2001,10(2):177-184.
[16]李琼妹,朱蔚仪,方小君,等.健康教育对提高心脏瓣膜置换术后患者抗凝治疗依从性的作用[J].现代临床护理,2013,12(5):76-78.
[17]杨莉莉,李荣,刘英,等.临床护理路径在心脏瓣膜置换围术期患者护理中的应用效果[J].解放军护理杂志,2015,32(14):44-48.
[18]肖玲,王攀,肖明朝,等.临床路径在冠脉介入治疗患者健康教育中应用效果的Meta分析[J].重庆医科大学学报,2016,41(12):1245-1249.
[2]HAIBO Z,JINZHONG L,YAN L,et al.Low-Intensity International Normalized Ratio(INR)Oral Anticoagulant Therapy in Chinese Patients with Mechanical Heart Valve Prostheses[J].Cell Biochem Biophys,2011,62(1):147-151.
[3]BEZUIDENHOUT D,WILLIAMS D F,ZILLA P.Polymeric heart valves for surgical implantation,catheter-based technologies and heart assist devices[J].Biomaterials,2015,36:6-25.
[4]颜海强,何昌进.心脏瓣膜病治疗的现状与发展[J].福建医药杂志,2014,36(2):140-141.
[5]周保利.临床路径应用指南[M].北京:北京大学医学出版社,2007.
[6]HIGGINS J,GREEN S R.Cochrane handbook for systematic reviews of interventions.4.2.6[J].Naunyn Schmiedebergs Arch Exp Pathol Pharmakol,2009,5(2):S38.
[7]胡雁.循证护理实践:护理学科发展的必然趋势[J].中国护理管理,2013,13(1):3-5.
[8]廖雪芳,杨红英,李燕.应用临床护理路径对心脏瓣膜置换术患者进行健康教育[J].齐鲁护理杂志,2007,13(16):101.
[9]罗玉华,李细森,张亚男,等.临床护理路径在心脏瓣膜置换术后抗凝健康教育中的应用[J].护理实践与研究,2009,6(16):37-39.
[10]刘静兰,刘琼,刘敏,等.健康教育路径对择期瓣膜置换手术患者康复的影响[J].中华现代护理杂志,2011,17(8):917-919.
[11]韦秋萍.心脏瓣膜置换术应用临床护理路径实施健康教育患者需求的调查报告[J].今日健康,2014,13(10):216-216.
[12]吴慧兰,周淑英,龙洪,等.临床护理路径在心脏瓣膜置换术后抗凝健康教育中的应用[J].护理研究,2014,28(10B):3641-3643.
[13]任瑞鲜,雷美兰.心脏瓣膜置换者实施临床路径健康教育的方法与效果[J].内蒙古医科大学学报,2015,37(s2):109-111.
[14]张念彩.临床护理路径在心脏瓣膜置换术后抗凝健康教育中的应用[J].养生保健指南,2016,(30):22.
[15]AAGAARD J,TINGLEFF J,HANSEN C N,et al.Twelve years'clinical experience with the CarboMedics prosthetic heart valve[J].J Heart Valve Dis,2001,10(2):177-184.
[16]李琼妹,朱蔚仪,方小君,等.健康教育对提高心脏瓣膜置换术后患者抗凝治疗依从性的作用[J].现代临床护理,2013,12(5):76-78.
[17]杨莉莉,李荣,刘英,等.临床护理路径在心脏瓣膜置换围术期患者护理中的应用效果[J].解放军护理杂志,2015,32(14):44-48.
[18]肖玲,王攀,肖明朝,等.临床路径在冠脉介入治疗患者健康教育中应用效果的Meta分析[J].重庆医科大学学报,2016,41(12):1245-1249.