การทบทวนหลักฐานเชิงประจักษ์เกี่ยวกับการปฏิบัติที่เป็นเลิศของการส่งเสริมการจัดการตนเองสำหรับผู้ป่วยภาวะหัวใจล้มเหลวเรื้อรัง

Abstract

Chronic heart failure is a major health problem worldwide. Patient self-management is very important in helping to slow down and reduce the severity of the disease and its complications. This systematic review of empirical evidence aimed to gather knowledge about how to promote self-management in patients with chronic heart failure. A systematic search was done to identify published and unpublished studies in Thai and English from 2006 to 2010. An Appraisal Form and Data Extract Form developed by Joanna Briggs Institute were used for this systematic review. Fourteen studies met the review criteria, 12 were randomized controlled trials and 2 were quasi-experimental studies. Narrative summarization was used to describe the characteristics of self-management promotion and determine its results. The findings revealed 4 types of interventions for self-management promotion in patients with chronic heart failure. These interventions included: 1) promotion of self-management through continuous monitoring; 2) exercise; 3) muscle relaxation techniques; and 4) home visits. These interventions varied in activities offered, frequency of contact, and program duration. Positive outcomes measured by these studies included reduced re-hospitalization rate, reduced length of hospital stay, reduced re-visits rates to the emergency department, reduced symptoms, and increased knowledge and self-management practice.