Home care workers in heart failure: a systematic review.
Home care workers in heart failure: a systematic review.
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DOI：
10.2147/jmdh.s175512
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发表时间：
2018
影响因子：
3.3
通讯作者：
Delgado D
中科院分区：
文献类型：
--
作者：
Sterling MR;Shaw AL;Leung PB;Safford MM;Jones CD;Tsui EK;Delgado D
家庭护理工作者（HCWs），包括家庭健康助手和个人护理助手，越来越多地被心力衰竭（HF）患者用于急性后护理和长期援助。尽管他们的存在越来越多，但他们在很大程度上被排除在心衰研究和干预之外。本系统综述旨在1)描述成人HF患者对HCWs的使用模式，2)检查HCWs对HF结局的影响，以及3)回顾涉及HCWs的HF干预措施。五个电子数据库（Ovid MEDLINE, Ovid EMBASE, Cochrane Library [Wiley]， CINAHL [EBSCO]和AgeLine [EBSCO]）从成立到2017年8月4日进行了检索。采用预先规定的纳入和排除标准筛选产率。两位作者独立审查参考文献，第三位审稿人在需要时充当仲裁员。数据从符合纳入标准的文章中提取。使用Downs和Black检查表进行质量评估。由于研究的异质性，我们进行了叙事综合。在被筛选的7032项研究中，13项进行了全文审查，6项符合纳入标准。两项描述性研究发现，单独生活并有功能和认知缺陷的成年心衰患者使用HCWs。虽然三项回顾性队列研究调查了心衰后HCW住院与再入院率之间的关系，但他们的发现是相互矛盾的。一项准实验研究发现，hcw提供的教育干预提高了心衰患者的自我护理能力。总体而言，尽管有一些重要的发现，但评估的研究质量较差（Downs和Black评分范围：10-16[28分]），大多数缺乏方法的严谨性。虽然HCWs很常见，但关于这些心衰辅助专业人员的文献是有限的。鉴于该领域研究的缺乏和本文综述的研究质量较低，需要进一步研究HCWs在心衰自我护理中的潜在作用以及成年心衰患者的预后。
Home care workers (HCWs), which include home health aides and personal care aides, are increasingly used by heart failure (HF) patients for post-acute care and long-term assistance. Despite their growing presence, they have largely been left out of HF research and interventions. This systematic review was aimed to 1) describe utilization patterns of HCWs by adults with HF, 2) examine the effect of HCWs on HF outcomes, and 3) review HF interventions that involve HCWs. Five electronic databases (Ovid MEDLINE, Ovid EMBASE, Cochrane Library [Wiley], CINAHL [EBSCO], and AgeLine [EBSCO]) were searched from inception through August 4, 2017. The yield was screened using prespecified inclusion and exclusion criteria. Two authors independently reviewed references and a third reviewer acted as an arbitrator when needed. Data were extracted from articles that met the inclusion criteria. The Downs and Black checklist was used for quality assessment. Due to study heterogeneity, a narrative synthesis was conducted. Of the 7,032 studies screened, 13 underwent full-text review, and six met the inclusion criteria. Two descriptive studies found that adults with HF who live alone and have functional and cognitive deficits utilize HCWs. While three retrospective cohort studies examined the association between having an HCW post-HF hospitalization and readmission rates, their findings were conflicting. One quasi-experimental study found that an HCW-delivered educational intervention improved HF patients’ self-care abilities. Overall, despite some significant findings, the studies assessed were of poor-to-fair quality (Downs and Black score range: 10–16 [28 total points]), with most lacking methodological rigor. Although HCWs are quite common, the literature on these paraprofessionals in HF is limited. Given the paucity of research in this area and the low quality of studies reviewed here, additional research is warranted on the potential role of HCWs in HF self-care and on outcomes among adults with HF.