远程心脏康复有效性及依从性的系统评价再评价

doi:10.3761/j.issn.0254-1769.2023.04.006

摘要/Abstract

摘要：

目的对远程心脏康复的有效性及依从性进行系统评价再评价。方法计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、澳大利亚乔安娜布里格斯研究所（Joanna Briggs Institute，JBI）循证卫生保健中心数据库、British Medical Journal最佳临床实践、Cochrane Library、PubMed、Embase、CINAHL数据库以及PROSPERO注册平台有关远程心脏康复的系统评价，检索时限为2012年2月—2022年10月，由2名研究者独立完成纳入文献的质量评价、资料提取。结果共纳入14篇系统评价，其中2篇质量等级为中，6篇质量等级为低，6篇质量为极低。重新Meta分析结果显示，应用通信技术、智能手机应用程序、可穿戴设备等的远程辅助措施可有效改善患者心肺功能、运动能力和生活质量等，但虚拟现实技术效果有待进一步验证。结论远程辅助可以提高心脏康复的有效性及依从性，但系统评价的方法学和证据的质量均较低，且多基于国外研究，证据应用时需进行本土化调试，并开展符合中国国情的高质量研究。

关键词: 远程康复, 心脏康复, 系统评价再评价, 循证护理学

Abstract:

Objective To overview the systematic reviews of effectiveness and compliance of remote cardiac rehabilitation based on digital technology. Methods CNKI，Wanfang，CBM，Cochrane Library，JBI，BMJ，PubMed，Embase，CINAHL，PROSPERO databases were searched to identify the relevant systematic reviews. The retrieval period was from February 2012 to October 2022，and 2 researchers screened systematic reviews and extracted the data independently. Results A total of 14 systematic reviews were included. The evaluation results showed that the quality level of 2 systematic reviews was medium，and 6 systematic reviews were at low level，and 6 were at very low level. The meta-analysis results show that the application of digital technology，including communication technology，APP，virtual reality，wearable devices and other remote assistance measures can effectively improve patients’ cardiopulmonary function，exercise ability and quality of life. However，the effect of virtual reality technology needs to be further verified. Conclusion Remote assistance can improve the effectiveness and compliance of cardiac rehabilitation，but the methodological quality of systematic evaluation and the quality of evidence are low，and most of them are based on foreign research. Localization debugging is needed when the evidence is applied，and high-quality research in line with Chinese national conditions should be carried out.

Key words: Telerehabilitation, Cardiac Rehabilitation, Overview of Systematic Reviews, Evidence-Based Nursing

郭卫婷, 刘建萍, 张晓雪, 张彬彬, 吴煜峥, 王文君. 远程心脏康复有效性及依从性的系统评价再评价[J]. 中华护理杂志, 2023, 58(4): 426-432.

GUO Wei-ting, LIU Jianping, ZHANG Xiaoxue, ZHANG Binbin, WU Yuzheng, WANG Wenjun. Effectiveness and compliance of remote cardiac rehabilitation：an overview of systematic reviews[J]. Chinese Journal of Nursing, 2023, 58(4): 426-432.

图/表 4

图1 PubMed检索策略

Figure 1 PubMed search strategies

表1 纳入文献的基本特征（n=14）

Table 1 Basic characteristics of included studies（n=14）

表2 纳入文献的主要干预措施及结论

Table 2 Main measures and conclusions of the included literature

表3 系统评价方法学质量评价工具文献质量评价清单（n=14）

Table 3 Assessment list of multiple system reviews 2（n=14）

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