Theory-based nursing interventions in adults with coronary heart disease: A systematic review and meta-analysis of randomized controlled trials

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Gök Metin Z., İzgü N., Gülbahar Eren M., Eroğlu H.


  • Publication Type: Article / Article
  • Publication Date: 2022
  • Doi Number: 10.1111/jnu.12839
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, Academic Search Premier, ASSIA, CINAHL, EMBASE, MEDLINE, Psycinfo
  • Page Numbers: pp.1-25
  • Lokman Hekim University Affiliated: No


AbstractPurpose: This systematic review and meta-analysis aimed to synthesize the outcomes of theory- based nursing interventions for coronary heart disease management.Design  and  Methods:  Web of Science, Scopus, Science Direct, and PubMed data-bases were electronically searched from January 2013 to August 2021. The Preferred Reporting  Item  for  Systematic  Reviews  and  Meta-analyses  statement  guidelines was followed for this meta-analysis. Randomized controlled trials on patients with coronary  heart  disease,  using  a  theory- based  nursing  intervention  were  eligible. Methodological quality was examined by two authors using the Modified Jadad Scale. Based on the heterogeneity test, the results were analyzed using a pool of data with 95% confidence intervals, p- values, and fixed or random-effect models (PROSPERO registration number X).Findings: A total of 1030 studies were initially retrieved, and 8 randomized controlled trials were eventually included in the meta-analysis after screening. The big majority (81.3%) of participants were males, and the mean age was 54.8 (SD =  8.7) years. This meta-    analysis found theory- based nursing interventions had no significant effect on blood lipid profile, blood pressure, and healthy lifestyle. However, these interventions significantly reduced fasting blood glucose, and body mass index and improved the physical and psychological domains of quality of life.Conclusions: The evidence from this meta-analysis reveals that theory- based nurs-ing interventions have a positive effect on fasting blood glucose, body mass index, and quality of life. However, their effects on blood lipid profile, blood pressure, and a healthy lifestyle are inconclusive. The results of this metanalysis are largely based on a few trials and were limited in terms of the number of outcomes. Conducting well-   designed randomized controlled trials with adequate power is needed to make a firm conclusion on the influence of theory- based nursing interventions on patient outcomes in the CHD population.Clinical  relevance:  Considering the high mortality and morbidity of coronary heart disease, nurses may play a significant role in coronary heart disease management by providing interventions that are based on a certain theoretical framework. This meta-    analysis  provides  insights  into  the  implementation  of  theory- based  nursing interventions in heart attack survivors or those newly diagnosed with coronary heart disease led by nurses and lasting longer than 6 months in coronary heart disease. In addition, future studies should consider enhancing the content of training programs for a healthy lifestyle within the theory- based nursing interventions and compare the effects of these interventions on acute and chronic coronary syndromes.

KEYWORDS: clinical trial, coronary heart disease, meta-analysis, model, nursing, systematic review, theory