ผลลัพธ์ทางคลินิกของรูปแบบโปรแกรมที่นำโดยพยาบาลในการฟื้นฟูสมรรถภาพหัวใจของผู้ป่วยภาวะหัวใจล้มเหลว: การทบทวนวรรณกรรมอย่างเป็นระบบ

Waiyaporn   Promwong; Jaroonsree  Meenongwah

doi:10.60099/jtnmc.v39i01.265987

Authors

Waiyaporn Promwong Boromrajonani College of Nursing, Sunpasitthiprasong, Faculty of Nursing Praboromarajchanok Institute, Ministry of Public Health, Thailand
Jaroonsree Meenongwah Boromrajonani College of Nursing, Sunpasitthiprasong, Faculty of Nursing Praboromarajchanok Institute, Ministry of Public Health, Thailand.

DOI:

https://doi.org/10.60099/jtnmc.v39i01.265987

Keywords:

nurse-led cardiac rehabilitation programs, clinical outcomes, heart failure, systematic review

Abstract

Introduction Patients with complex conditions experiencing heart failure require long-term care and are at risk of hospitalization. Therefore, cardiac rehabilitation (CR) becomes vital to enhance clinical outcomes and decrease overall mortality risks.

Objective To assess clinical outcomes of the nurse-led cardiac rehabilitation programs (NLCRP) in patients with heart failure.

Design This study employed a systematic review.

Methodology The studies included in this review comprised randomized controlled trials (RCTs), both published and unpublished, in Thai and English between 2014 and 2023. The search comprised the following databases: Thai Thesis Database, ThaiJo, PubMed, CINAHL, Clinical Key for Nursing, ScienceDirect, and ProQuest Nursing. The selected studies underwent appraisal utilizing critical appraisal tools developed by the Joanna Briggs Institute, and their key findings were extracted. Data analysis was conducted using a summary narrative approach.

Results Seven RCTs met the inclusion criteria. The CR programs applied concepts and theories including motivational interviewing, empowerment, perceived self-efficacy, and the theory of planned behavior. The intervention mainly focused on an exercise alone. Program outcomes demonstrated improvements in laboratory test results, functional capacity, and quality of life, except for B-type natriuretic peptide (BNP) levels. However, it is important to note that these conclusions are derived from 1-3 studies for each clinical outcome. While this systematic review supports the NLCRP, the limited number of studies on the NLCRP prevents a clear confirmation of its efficacy.

Recommendations Further research is necessary to assess the effectiveness of the NLCRP. Nurses should provide health education using motivational interviewing for home-based cardiac rehabilitation, and telephone support.

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