Efficacy of discharge preparation service on intervention of elderly patients with chronic diseases: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

GAI Qiongyan ^1,2 , WU Mengting ^2,3 , LI Chen ^2,3 , ZHOU Yueqin ^2,3 , LI Juhe ⁴ ,  BAI Zhenggang ^2,3

1. Department of Urology, Drum Tower Hospital Affiliated to Medical College of Nanjing University, Nanjing, 210008, P.R.China;
2. Evidence-Based Research Center of Social Science & Health, Public Affair School, Nanjing University of Science and Technology, Nanjing, 210094, P.R.China;
3. Master of Social Work (MSW) Education Center, Public Affair School, Nanjing University of Science and Technology, Nanjing, 210094, P.R.China;
4. Social Work Association of Jiangsu Province, Nanjing, 210094, P.R.China;

Corresponding author：

BAI Zhenggang, Email: baizhenggang@126.com

Keywords：

Discharge preparation service; Chronic diseases of aging; Randomized controlled trial; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.201907012

Video：

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Objective To systematically review the efficacy of discharge preparation service in elderly patients with chronic diseases.Methods CNKI, WanFang Data, VIP, Web of Science, The Cochrane Library, PubMed and EMbase databases were electronically searched to collect randomized controlled trails (RCTs) on the discharge preparation service for elderly patients with chronic diseases from January, 2000 to January, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.Results A total of 7 RCTs, involving 884 patients were included. The results of meta-analysis showed that: after the hospitalization preparation service, the incidence of acute complication (RR=0.38, 95%CI 0.15 to 0.98, P=0.04), patient compliance behavior (SMD=0.54, 95% CI 0.25 to 0.83, P=0.000 3), exercise capacity (SMD=2.65, 95%CI 0.25 to 5.04, P=0.03), and nursing satisfaction (SMD=0.71, 95%CI 0.10 to 1.33, P=0.02) significantly improved. However, there were no significant differences in emergency hospital admission for acute complications (RR=0.25, 95%CI 0.06 to 1.11, P=0.07), self-care ability (SMD=2.18, 95%CI −1.02 to 5.38, P=0.18), activity of daily living (ADL) (SMD=0.56, 95%CI −0.47 to 1.59, P=0.28).Conclusions The current evidence shows that after implementation of the discharge preparation service, the incidence of acute complication, compliance behavior, exercise ability, and service satisfaction of the elderly patients with chronic diseases are significantly improved. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusion.

Citation： GAI Qiongyan, WU Mengting, LI Chen, ZHOU Yueqin, LI Juhe, BAI Zhenggang. Efficacy of discharge preparation service on intervention of elderly patients with chronic diseases: a systematic review. Chinese Journal of Evidence-Based Medicine, 2020, 20(3): 289-295. doi: 10.7507/1672-2531.201907012 Copy

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9.	陈秀秀. 老年慢性病患者心理特点及护理对策. 心理月刊, 2018, (12): 29.
10.	唐晴, 蒋运兰, 王蓉. 连续护理模式在糖尿病护理中的应用. 当代护士(下旬刊), 2014, (3): 7-9.
11.	赵紫薇. 社会支持理论视域下老年人长期照顾服务体系建构研究. 劳动保障世界, 2017, (27): 40.
12.	蒋超, 蒲杰, 谢静. 我国台湾地区医院出院准备服务的特点及启示. 中国医疗管理科学, 2017, 7(2): 27-30.
13.	李素平, 景春华. 出院准备在老年慢性病患者中的实践与思考. 实用临床护理学电子杂志, 2017, 2(51): 41-42.
14.	刘凌. 慢性阻塞性肺疾病出院计划方案构建及应用研究. 杭州: 杭州师范大学, 2012.
15.	陆凤, 赵秀芳. 出院准备服务的应用和发展现状. 检验医学与临床, 2017, 14(Z1): 394-396.
16.	胡真一. “出院计划”跨领域团队中社工角色弱化的困境研究. 吉林: 吉林大学, 2018.
17.	陈琴, 姜小鹰, 钟清玲, 等. 出院计划模式对慢性阻塞性肺疾病患者自我效能的影响. 护士进修杂志, 2012, 27(12): 1126-1129.
18.	Donald F, Kilpatrick K, Reid K, et al. Hospital to community transitional care by nurse practitioners: a systematic review of cost effectiveness. Int J Nurs Stud, 2015, 52(1): 436-451.
19.	吕露露, 郭红, 柳清霞, 等. 出院计划对脑卒中患者及其照顾者干预效果的系统评价. 上海护理, 2018, 18(2): 13-20.
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23.	韩珮莹, 房芳, 马杰. 出院计划在老年类风湿性关节炎患者中的应用效果. 解放军护理杂志, 2018, 35(3): 69-72.
24.	刘雪梅. 出院计划模式对 162 例老年脑卒中患者遵医行为的影响. 中国医疗前沿, 2013, (9): 112-113.
25.	高丽芬, 崇瑶. 出院计划干预对提升老年胸腰椎骨折术后自我护理能力的研究. 中西医结合心血管病电子杂志, 2017, 5(34): 9-10.
26.	吴玉兰. 出院计划服务对老年 COPD 患者知识, 信念及行为结果的影响. 医学信息, 2014, (17): 159-160.
27.	黄斌英. 出院计划对脑卒中患者预后的影响. 广州: 南方医科大学, 2012.
28.	Shyu YI, Chen MC, Chen ST, et al. A family caregiver-oriented discharge planning program for older stroke patients and their family caregivers. J Clin Nurs, 2008, 17(18): 2497-2508.
29.	倪圆圆, 冀璇, 石磊, 等. 过渡期护理模式降低我国老年慢性病病人再入院率的系统评价. 护理研究, 2017, 31(29): 3684-3687.
30.	刘曼, 刘晓亭, 董博, 等. 延续性护理对冠心病患者抑郁情绪影响的系统评价. 护理学报, 2017, (1): 47-52.
31.	沈翠玲, 刘芳, 姚立群, 等. 出院准备服务对脑卒中患者日常生活活动能力的影响. 实用临床护理学电子杂志, 2017, 2(11): 1-2, 4.

1. 翟晓晴, 李卉青, 黄敏, 等. 居家护理在老年慢性病患者出院延续性护理中的应用. 中华现代护理杂志, 2012, 18(32): 3870-3872.
2. 刘鹏程, 马丽萍. 让亿万老年人和家庭未来可期-近年来养老服务业创新发展综述. 中国社会工作, 2019, (11): 7-8.
3. 中华人民共和国中央人民政府. 2020 年我国老年人口将达到 2.4 亿, 慢性病负担重. Available at: http://www.gov.cn/xinwen/2016-09/28/content_5113197.htm.
4. 中华人民共和国国家卫生和计划生育委员会. 中国疾病预防控制工作进展(2015 年). Available at: http://www.nhfpc.gov.cn/xcs/s3574/201504/03729279b0dd47e282500f8c22f2cfbb.shtml, 2015-04-10.
5. 张冉, 路云, 张闪闪, 等. 中国老年人慢性病共病患病模式及疾病相关性分析. 中国公共卫生, 2019, 35(8): 1003-1005.
6. Mcrae I, Yen L, Jeon YH, et al. Multim or bidity is associated with higher out-of-pocket spending: a study of older Australians with multiple chronic conditions. Aust J Prim Health, 2013, 19(2): 144-149.
7. Wolff JL, Starfield B, Anderson G. Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch Int Med, 2002, 162(20): 2269-2276.
8. 周建红, 王建芳, 陈燕珏, 等. 老年慢性病患者出院后居家介护式护理模式效果评价. 中国初级卫生保健, 2019, 33(2): 83-85.
9. 陈秀秀. 老年慢性病患者心理特点及护理对策. 心理月刊, 2018, (12): 29.
10. 唐晴, 蒋运兰, 王蓉. 连续护理模式在糖尿病护理中的应用. 当代护士(下旬刊), 2014, (3): 7-9.
11. 赵紫薇. 社会支持理论视域下老年人长期照顾服务体系建构研究. 劳动保障世界, 2017, (27): 40.
12. 蒋超, 蒲杰, 谢静. 我国台湾地区医院出院准备服务的特点及启示. 中国医疗管理科学, 2017, 7(2): 27-30.
13. 李素平, 景春华. 出院准备在老年慢性病患者中的实践与思考. 实用临床护理学电子杂志, 2017, 2(51): 41-42.
14. 刘凌. 慢性阻塞性肺疾病出院计划方案构建及应用研究. 杭州: 杭州师范大学, 2012.
15. 陆凤, 赵秀芳. 出院准备服务的应用和发展现状. 检验医学与临床, 2017, 14(Z1): 394-396.
16. 胡真一. “出院计划”跨领域团队中社工角色弱化的困境研究. 吉林: 吉林大学, 2018.
17. 陈琴, 姜小鹰, 钟清玲, 等. 出院计划模式对慢性阻塞性肺疾病患者自我效能的影响. 护士进修杂志, 2012, 27(12): 1126-1129.
18. Donald F, Kilpatrick K, Reid K, et al. Hospital to community transitional care by nurse practitioners: a systematic review of cost effectiveness. Int J Nurs Stud, 2015, 52(1): 436-451.
19. 吕露露, 郭红, 柳清霞, 等. 出院计划对脑卒中患者及其照顾者干预效果的系统评价. 上海护理, 2018, 18(2): 13-20.
20. Moher D, Liberati A, Tetzlaff J, et al. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. Open Med, 2009, 6(7): e1000097.
21. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions (version 5.1.0). The Cochrane Collaboration, 2011. Available at: http://www.cochrane-handbook.org.
22. 陆连娣, 潘奎静, 翟晓晴, 等. 出院准备服务在老年 2 型糖尿病患者中的应用研究. 实用老年医学, 2015, 29(12): 79-81.
23. 韩珮莹, 房芳, 马杰. 出院计划在老年类风湿性关节炎患者中的应用效果. 解放军护理杂志, 2018, 35(3): 69-72.
24. 刘雪梅. 出院计划模式对 162 例老年脑卒中患者遵医行为的影响. 中国医疗前沿, 2013, (9): 112-113.
25. 高丽芬, 崇瑶. 出院计划干预对提升老年胸腰椎骨折术后自我护理能力的研究. 中西医结合心血管病电子杂志, 2017, 5(34): 9-10.
26. 吴玉兰. 出院计划服务对老年 COPD 患者知识, 信念及行为结果的影响. 医学信息, 2014, (17): 159-160.
27. 黄斌英. 出院计划对脑卒中患者预后的影响. 广州: 南方医科大学, 2012.
28. Shyu YI, Chen MC, Chen ST, et al. A family caregiver-oriented discharge planning program for older stroke patients and their family caregivers. J Clin Nurs, 2008, 17(18): 2497-2508.
29. 倪圆圆, 冀璇, 石磊, 等. 过渡期护理模式降低我国老年慢性病病人再入院率的系统评价. 护理研究, 2017, 31(29): 3684-3687.
30. 刘曼, 刘晓亭, 董博, 等. 延续性护理对冠心病患者抑郁情绪影响的系统评价. 护理学报, 2017, (1): 47-52.
31. 沈翠玲, 刘芳, 姚立群, 等. 出院准备服务对脑卒中患者日常生活活动能力的影响. 实用临床护理学电子杂志, 2017, 2(11): 1-2, 4.

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Efficacy of discharge preparation service on intervention of elderly patients with chronic diseases: a systematic review

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