技术辅助心脏康复的有效性：系统评价和荟萃分析

技术辅助心脏康复的有效性：系统评价和荟萃分析大数据实验室解决方案,仙鼎,於书凝, 作者：NursingResearch护理研究前 分享智慧 共同成长 Abstract Objectives The objectives of this review were to identify different technology-assisted intervention

作者：NursingResearch护理研究前

分享智慧

共同成长

Abstract

Objectives

The objectives of this review were to identify different technology-assisted interventions in cardiac rehabilitation, to explore and examine the effectiveness of technology-assisted cardiac rehabilitation.

Design

A systematic review and meta-analysis.

Methods

A systematic search was performed on six electronic databases: CINALH Complete, Cochrane Library, PubMed, MEDLINE via OvidSP, British Nursing Index and PsycINFO to identify randomised controlled trials from 2010 to 2020. Selection of studies was performed by screening the titles, abstracts and full texts, and two reviewers independently and critically appraised the included studies using the revised Cochrane risk of bias tool for randomized trials (RoB 2).

Results

Nine randomised controlled trials met the inclusion criteria; five studies with some bias concerns related to allocation concealment (n = 2) and measurement of outcome (n = 4), and four studies were of low risk of bias. The pooled effect size showed comparable effectiveness between technology-assisted cardiac rehabilitation and conventional/centre-based cardiac rehabilitation on modifiable coronary risk factors (systolic and diastolic blood pressure, total cholesterol, p>0.05), psychological outcomes (anxiety: SMD 0.25, 95% CI -0.11 to 0.62, p = 0.17 and depression: SMD 0.09, 95% CI -0.16 to 0.35, p = 0.47). Narrative synthesis was performed for adherence to prescribed exercise sessions in cardiac rehabilitation. No significant adverse events occurred. The adverse events that did occur were self-reported, mostly unrelated to the interventions with technology and the number of events was comparable between both groups. Inconsistent results were found across the studies. This review revealed lack of self-efficacy and behaviour change theories/strategies, and educational emphasis among studies.

Conclusions

The results in the meta-analysis have indicated that technology-assisted cardiac rehabilitation demonstrated comparable results to conventional/centre-based cardiac rehabilitation. Technology-assisted cardiac rehabilitation is a potential alternative not only to remove cardiac rehabilitation barriers but also in the midst of current prolonged pandemic. Future studies on technology-assisted cardiac rehabilitation with the emphasis behavior change theories/strategies and education are required.

摘要翻译（仅供参考）

目标 本综述的目的是确定心脏康复中不同的技术辅助干预措施，探索和检验技术辅助心脏康复的有效性。 设计

系统评价和荟萃分析。

方法

对六个电子数据库进行了系统搜索：CINALH Complete、Cochrane Library 、PubMed、MEDLINE via OvidSP、British Nursing Index和PsycINFO，以确定 2010 年至 2020 年的随机对照试验。通过筛选标题、摘要和全文进行研究选择文本，两名审稿人使用经修订的 Cochrane 随机试验偏倚风险工具（RoB 2）独立和批判性地评估了纳入的研究。

结果

9项随机对照试验符合纳入标准；五项与分配隐藏相关的偏倚问题的研究（n = 2) 和测量结果 (n = 4)，四项研究的偏倚风险较低。汇总效应大小显示，技术辅助心脏康复和传统/中心心脏康复对可改变的冠状动脉危险因素（收缩压和舒张压、总胆固醇、p>0.05），心理结果（焦虑：SMD 0.25，95% CI -0.11 到 0.62， p = 0.17 和抑郁：SMD 0.09，95% CI -0.16 到 0.35， p = 0.47）。进行叙述合成以坚持心脏康复中规定的锻炼课程。没有发生显着的不良事件。确实发生的不良事件是自我报告的，大多与技术干预无关，并且两组之间的事件数量具有可比性。在所有研究中发现不一致的结果。该审查显示缺乏自我效能和行为改变的理论/策略，以及研究之间的教育重点。

结论

荟萃分析的结果表明，技术辅助的心脏康复与传统/以中心为基础的心脏康复具有可比性。技术辅助的心脏康复是一种潜在的替代方案，不仅可以消除心脏康复障碍，而且可以在当前长期流行的情况下进行。未来需要对技术辅助心脏康复进行研究，重点是行为改变理论/策略和教育。

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