改善急性心肌梗死后的过渡性护理:范围综述。

Filipa Homem, Anaísa Reveles, António Amaral, Verónica Coutinho, Lino Gonçalves
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引用次数: 0

摘要

心血管疾病仍然是发病率和死亡率的主要原因,给全球医疗保健系统带来了巨大挑战。过渡性护理干预措施可确保患者在不同级别医疗机构之间转诊时护理的协调性和连续性,已被证明可减少不必要的医疗使用并改善患者预后。尽管人们对心力衰竭的过渡性护理给予了极大关注,但本综述旨在对急性心肌梗死(AMI)患者实施的干预措施进行梳理。我们按照乔安娜-布里格斯研究所(Joanna Briggs Institute,JBI)的方法进行了范围界定综述,在Cochrane、CINAHL、MEDLINE、JBI和SciELO数据库中进行了文献检索,重点关注2013年以来葡萄牙语和英语的出版物。共纳入 75 项研究,其中大部分研究结合了有助于改善心血管健康状况的多种干预措施,包括提高对健康生活方式行为的依从性、增强药物依从性和改善医疗保健自我管理。这些干预措施能有效减少与心血管相关的急诊就诊率、30 天非计划再入院率以及首次心肌梗死后的死亡率。确定的主要策略包括出院规划、数字健康解决方案、门诊护理和医疗保健协调。本综述的研究结果表明,有必要制定相关方法,以加强急性心肌梗死后从医院到基层医疗机构的护理过渡。目前迫切需要设计和实施新的医疗保健计划,将出院干预、数字健康、门诊护理和医疗保健协调结合起来,以确保护理的连续性并优化患者出院后的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Improving transitional care after acute myocardial infarction: A scoping review

Cardiovascular disease remains the leading cause of morbidity and mortality, posing a significant challenge to healthcare systems worldwide. Transitional care interventions, which ensure coordination and continuity of care as patients move between different levels of healthcare, have been shown to reduce unnecessary healthcare utilization and improve patient outcomes. While much attention has been given to transitional care in heart failure, this review aims to map the interventions implemented for patients following an acute myocardial infarction (AMI). A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology, with literature searches performed in the Cochrane, CINAHL, MEDLINE, JBI, and SciELO databases, focusing on publications from 2013 onwards in both Portuguese and English. Seventy-five studies were included, with most combining multiple interventions that contributed to improved cardiovascular health outcomes, including increased adherence to healthy lifestyle behaviors, enhanced medication compliance, and better healthcare self-management. These interventions were effective in reducing cardiovascular-related Emergency Department visits, unplanned 30-day readmissions, and mortality following a first-time myocardial infarction. Key strategies identified included discharge planning, digital health solutions, outpatient care, and healthcare coordination. The findings of this review underscore the need for developing methodologies that enhance the transition of care from hospital to primary care following an AMI. There is an urgent need to design and implement new healthcare programs that integrate discharge interventions, digital health, outpatient care, and healthcare coordination to ensure continuity of care and optimize patient outcomes post-discharge.

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