ABSTRACT

Objectives

Identify non-pharmacological interventions to support patient/caregiver dyads with ACSCs; review the effects of dyadic interventions on health services outcomes; and review the effectiveness of dyadic interventions on patient and caregiver biopsychosocial outcomes.

Methods

A systematic review of randomized controlled trials (RCTs).

Results

Twenty-six manuscripts representing 20 unique RCTs (Mean N = 154 patients, 140 caregivers) were eligible. Eleven RCTs examined caregiving in patients with HF, seven with T2DM, one with COPD, and one with mixed ACSCs. Dyadic interventions for ACSCs were diverse in terms of length and content, with most including an educational component. Only 4/26 included studies had a low risk of bias. Interventions were most successful at improving quality of life, clinical health outcomes, health behaviors, and health services outcomes, with fewer improvements in patient mental health outcomes, psychosocial outcomes, relationship outcomes, and caregiver outcomes in general. The largest effect sizes were reported from trials focused on T2DM.

Conclusions

High-quality research with consistent measuring instruments is needed to understand which interventions are associated with improved patient and caregiver outcomes.

Clinical Implications

There may be clinically relevant benefits to including caregivers in interventions for patients with ACSCs, and clinicians should consider this when devising treatment plans.

中文翻译：

---

对门诊护理敏感病症的二元干预的系统评价：当前证据和关键差距

摘要

目标

确定非药物干预措施，以支持具有 ACSC 的患者/护理人员二人组；审查二元干预对卫生服务结果的影响；并审查二元干预对患者和护理人员生物心理社会结果的有效性。

方法

随机对照试验（RCT）的系统评价。

结果

代表 20 项独特 RCT（平均 N = 154 名患者，140 名护理人员）的 26 篇手稿符合条件。11 项 RCT 研究了 HF 患者的护理，7 例 T2DM 患者，1 例 COPD 患者和 1 例混合 ACSCs 患者。ACSC 的二元干预在长度和内容方面各不相同，其中大多数都包括教育部分。只有 4/26 的纳入研究具有低偏倚风险。干预措施在改善生活质量、临床健康结果、健康行为和健康服务结果方面最为成功，但对患者心理健康结果、心理社会结果、关系结果和照顾者结果的改善较少。最大的效应量来自针对 T2DM 的试验。

结论

需要使用一致的测量仪器进行高质量的研究，以了解哪些干预措施与改善患者和护理人员的结果相关。

临床意义

将护理人员纳入 ACSC 患者的干预措施可能具有临床相关益处，临床医生在制定治疗计划时应考虑这一点。