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

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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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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.
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8.	周建紅, 王建芳, 陳燕玨, 等. 老年慢性病患者出院后居家介護式護理模式效果評價. 中國初級衛生保健, 2019, 33(2): 83-85.
9.	陳秀秀. 老年慢性病患者心理特點及護理對策. 心理月刊, 2018, (12): 29.
10.	唐晴, 蔣運蘭, 王蓉. 連續護理模式在糖尿病護理中的應用. 當代護士(下旬刊), 2014, (3): 7-9.
11.	趙紫薇. 社會支持理論視域下老年人長期照顧服務體系建構研究. 勞動保障世界, 2017, (27): 40.
12.	蔣超, 蒲杰, 謝靜. 我國臺灣地區醫院出院準備服務的特點及啟示. 中國醫療管理科學, 2017, 7(2): 27-30.
13.	李素平, 景春華. 出院準備在老年慢性病患者中的實踐與思考. 實用臨床護理學電子雜志, 2017, 2(51): 41-42.
14.	劉凌. 慢性阻塞性肺疾病出院計劃方案構建及應用研究. 杭州: 杭州師范大學, 2012.
15.	陸鳳, 趙秀芳. 出院準備服務的應用和發展現狀. 檢驗醫學與臨床, 2017, 14(Z1): 394-396.
16.	胡真一. “出院計劃”跨領域團隊中社工角色弱化的困境研究. 吉林: 吉林大學, 2018.
17.	陳琴, 姜小鷹, 鐘清玲, 等. 出院計劃模式對慢性阻塞性肺疾病患者自我效能的影響. 護士進修雜志, 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.	呂露露, 郭紅, 柳清霞, 等. 出院計劃對腦卒中患者及其照顧者干預效果的系統評價. 上海護理, 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.
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22.	陸連娣, 潘奎靜, 翟曉晴, 等. 出院準備服務在老年 2 型糖尿病患者中的應用研究. 實用老年醫學, 2015, 29(12): 79-81.
23.	韓珮瑩, 房芳, 馬杰. 出院計劃在老年類風濕性關節炎患者中的應用效果. 解放軍護理雜志, 2018, 35(3): 69-72.
24.	劉雪梅. 出院計劃模式對 162 例老年腦卒中患者遵醫行為的影響. 中國醫療前沿, 2013, (9): 112-113.
25.	高麗芬, 崇瑤. 出院計劃干預對提升老年胸腰椎骨折術后自我護理能力的研究. 中西醫結合心血管病電子雜志, 2017, 5(34): 9-10.
26.	吳玉蘭. 出院計劃服務對老年 COPD 患者知識, 信念及行為結果的影響. 醫學信息, 2014, (17): 159-160.
27.	黃斌英. 出院計劃對腦卒中患者預后的影響. 廣州: 南方醫科大學, 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.	倪圓圓, 冀璇, 石磊, 等. 過渡期護理模式降低我國老年慢性病病人再入院率的系統評價. 護理研究, 2017, 31(29): 3684-3687.
30.	劉曼, 劉曉亭, 董博, 等. 延續性護理對冠心病患者抑郁情緒影響的系統評價. 護理學報, 2017, (1): 47-52.
31.	沈翠玲, 劉芳, 姚立群, 等. 出院準備服務對腦卒中患者日常生活活動能力的影響. 實用臨床護理學電子雜志, 2017, 2(11): 1-2, 4.

1. 翟曉晴, 李卉青, 黃敏, 等. 居家護理在老年慢性病患者出院延續性護理中的應用. 中華現代護理雜志, 2012, 18(32): 3870-3872.
2. 劉鵬程, 馬麗萍. 讓億萬老年人和家庭未來可期-近年來養老服務業創新發展綜述. 中國社會工作, 2019, (11): 7-8.
3. 中華人民共和國中央人民政府. 2020 年我國老年人口將達到 2.4 億, 慢性病負擔重. Available at: http://www.gov.cn/xinwen/2016-09/28/content_5113197.htm.
4. 中華人民共和國國家衛生和計劃生育委員會. 中國疾病預防控制工作進展(2015 年). Available at: http://www.nhfpc.gov.cn/xcs/s3574/201504/03729279b0dd47e282500f8c22f2cfbb.shtml, 2015-04-10.
5. 張冉, 路云, 張閃閃, 等. 中國老年人慢性病共病患病模式及疾病相關性分析. 中國公共衛生, 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. 周建紅, 王建芳, 陳燕玨, 等. 老年慢性病患者出院后居家介護式護理模式效果評價. 中國初級衛生保健, 2019, 33(2): 83-85.
9. 陳秀秀. 老年慢性病患者心理特點及護理對策. 心理月刊, 2018, (12): 29.
10. 唐晴, 蔣運蘭, 王蓉. 連續護理模式在糖尿病護理中的應用. 當代護士(下旬刊), 2014, (3): 7-9.
11. 趙紫薇. 社會支持理論視域下老年人長期照顧服務體系建構研究. 勞動保障世界, 2017, (27): 40.
12. 蔣超, 蒲杰, 謝靜. 我國臺灣地區醫院出院準備服務的特點及啟示. 中國醫療管理科學, 2017, 7(2): 27-30.
13. 李素平, 景春華. 出院準備在老年慢性病患者中的實踐與思考. 實用臨床護理學電子雜志, 2017, 2(51): 41-42.
14. 劉凌. 慢性阻塞性肺疾病出院計劃方案構建及應用研究. 杭州: 杭州師范大學, 2012.
15. 陸鳳, 趙秀芳. 出院準備服務的應用和發展現狀. 檢驗醫學與臨床, 2017, 14(Z1): 394-396.
16. 胡真一. “出院計劃”跨領域團隊中社工角色弱化的困境研究. 吉林: 吉林大學, 2018.
17. 陳琴, 姜小鷹, 鐘清玲, 等. 出院計劃模式對慢性阻塞性肺疾病患者自我效能的影響. 護士進修雜志, 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. 呂露露, 郭紅, 柳清霞, 等. 出院計劃對腦卒中患者及其照顧者干預效果的系統評價. 上海護理, 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. 陸連娣, 潘奎靜, 翟曉晴, 等. 出院準備服務在老年 2 型糖尿病患者中的應用研究. 實用老年醫學, 2015, 29(12): 79-81.
23. 韓珮瑩, 房芳, 馬杰. 出院計劃在老年類風濕性關節炎患者中的應用效果. 解放軍護理雜志, 2018, 35(3): 69-72.
24. 劉雪梅. 出院計劃模式對 162 例老年腦卒中患者遵醫行為的影響. 中國醫療前沿, 2013, (9): 112-113.
25. 高麗芬, 崇瑤. 出院計劃干預對提升老年胸腰椎骨折術后自我護理能力的研究. 中西醫結合心血管病電子雜志, 2017, 5(34): 9-10.
26. 吳玉蘭. 出院計劃服務對老年 COPD 患者知識, 信念及行為結果的影響. 醫學信息, 2014, (17): 159-160.
27. 黃斌英. 出院計劃對腦卒中患者預后的影響. 廣州: 南方醫科大學, 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. 倪圓圓, 冀璇, 石磊, 等. 過渡期護理模式降低我國老年慢性病病人再入院率的系統評價. 護理研究, 2017, 31(29): 3684-3687.
30. 劉曼, 劉曉亭, 董博, 等. 延續性護理對冠心病患者抑郁情緒影響的系統評價. 護理學報, 2017, (1): 47-52.
31. 沈翠玲, 劉芳, 姚立群, 等. 出院準備服務對腦卒中患者日常生活活動能力的影響. 實用臨床護理學電子雜志, 2017, 2(11): 1-2, 4.

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Chinese Journal of Evidence-Based Medicine

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

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