结构化健康教育对冠心病患者生活质量及终末事件影响的系统评价  

Effect of structured health education on quality of life and the end point of patients with coronary disease： a systematic review and Meta-analysis

作　　者：史宇颖 范琳琳[1] 耿桂灵[1] 丁蕾[1] 吴敏 

机构地区：[1]南通大学护理学院,226001 [2]湖北省人民医院心内科3病区

出　　处：《中国实用护理杂志》2015年第4期235-240,共6页Chinese Journal of Practical Nursing

基　　金：教育部人文社会科学研究规划基金项目（14YJAZH022）

摘　　要：目的采用循证方法系统评价结构化健康教育对冠心病（CHD）患者生活质量及终末事件的影响。方法检索the Coehrane Library、Coehrane Database of Systematic Reviews（CDSR）、Medline（OVID）、Pubmed、Web of Science等数据库中国外关于结构化健康教育对冠心病患者生活质量及终末事件的随机对照实验（RCT）研究，采用Jadad评分标准评价纳入文献的方法学质量，RevMan5．2软件对数据进行Meta分析。结果共纳入12篇RCT文献，方法学质量评价均为B级及以上。干预组20476例，对照组14522例。Meta分析结果显示：采用结构化健康教育的干预组患者生活质量得分明显高于对照组，其WMD为3．29，95％CI（0．49～6．09），而心血管事件发生率、再入院率及死亡率2组比较差异无统计学意义，RR及95％CI分别为0．72（0．50～1．04）、0．98（0．86～1．11）、0．77（0．58～1．03）。结论结构化健康教育可以改善冠心病患者的生活质量，但对心血管事件、再入院率及死亡率无显著影响，建议今后的研究中可通过开展延续护理来降低其发生率。Objective We sought to evaluate the effect of structured health education on quality of life and the end point of patients with coronary disease with evidence- based method. Methods The Cochrane Library, Cochrane Database of Systematic Reviews （CDSR）, Medline （OVID）, Pubmed and Web of Science were searched to collect the randomized controlled trials （RCT） which mentioned the structured health education to CHD patients, the quality of the RCTs was evaluated by Jadad Score, then effective data were extracted and analyzed by Meta-analysis with RevMan 5.2 software. Results A total of 12 eligible studies of RCT were included in the study with Jadad Score evaluations at B level or above. There were 20 476 cases in the intervention group, 14 522 cases in the control group. Meta-analysis showed that the quality of life scores of the intervention group were significantly higher than those of the control group, weighted mean difference was 3.29,95% CI （0.49-6.09）. No significant difference was found in cardiac morbidity outcomes, re-hospitalization and the mortality rate, relative risk, 95% confidence interval were respectively 0.72（0.50-1.04）, 0.98（0.86-1.11）, 0.77（0.58-1.03）. Conclusions The structured health education can improve the quality of life of patients with coronary disease, but has no obvious effect on the cardiac morbidity outcomes, re-hospitalization and mortality rate. We suggest transitional care to be carried out in future research to decrease the incidence rates of them.

关 键 词：冠状动脉粥样硬化性心脏病 结构化健康教育 生活质量 META分析 

分 类 号：R473.5[医药卫生—护理学]