慢性心力衰竭患者自我管理的最佳证据总结

Summary of the best evidence for self-management in patients with chronic heart failure

目的检索、评价和总结慢性心力衰竭患者自我管理相关证据,为医护人员进行自我管理健康教育、规范患者自我管理行为提供循证依据。方法按照“6S”证据模型检索UpToDate、BMJ Best Practice、乔安娜布里格斯研究所循证卫生保健中心数据库、英国国家卫生与临床优化研究所网站、国际指南协作网、美国国立指南库、苏格兰院际间指南网、Cochrane Library、医脉通、梅斯医学、PubMed、中国生物医学文献数据库、中国知网及万方数据知识服务平台有关慢性心力衰竭患者自我管理相关文献,文献类型包括临床决策、系统评价、指南、专家共识及原始研究等,检索时限为建库至2022年7月14日。由3名研究人员对文献进行质量评价,2名研究员进行证据提取和整合。结果共纳入18篇文献,包括1篇临床决策、10篇指南、2篇系统评价、3篇随机对照试验、2篇专家共识。围绕多学科团队合作、学习疾病相关知识、用药管理、症状监测、运动训练、饮食与营养、生活方式、心理调节、就医及随访等9个方面总结出39条证据。结论该研究总结了慢性心力衰竭患者自我管理的最佳证据,可为临床医护人员提供借鉴和参考,使其能更全面、更科学的为慢性心力衰竭患者进行自我管理提供指导。

Objective To retrieve,evaluate and summarize the evidence of self-management of patients with chronic heart failure,and to provide evidence-based bases for medical staff to conduct self-management health education and standardize patients’self-management behavior.Methods We searched UpToDate,BMJ Best Practice,Joanna Briggs Institute(JBI),National Institute for Health and Clinical Excellence(NICE),Guidelines International Network(GIN),National Guideline Clearinghouse(NGC),Scottish Intercollegiate Guidelines Network(SIGN),Cochrane Library,PubMed,SinoMed,CNKI,Wanfang Database to collect relevant clinical decisions,evidence summaries,syste-matic reviews,guidelines,expert consensuses and original articles published from the databases establishment to July 14,2022.There were 3 researchers who evaluated the quality of the literature that met the quality standards,and 2 researchers extracted and integrated evidence.Results A total of 18 pieces of literature were included,including 1 clinical decision,10 guidelines,2 systematic reviews,3 randomized controlled trials and 2 expert consensuses.Finally,39 pieces of evidence were summarized in 9 aspects,including multidisciplinary team cooperation,learning disease-related knowledge,medication management,symptom monitoring,exercise training,dietary and nutrition,lifestyle,psychological adjustment,medical treatment and follow-up.Conclusion This study summarizes the best evidence of self-management of patients with chronic heart failure,which can provide references for clinical medical staff to guide self-management of patients with chronic heart failure in a more comprehensive and scientific way.