| Objectives:To assess the effectiveness of transitional care in China through comprehensiveliterature search and provide effective evidence for Evidence-based Health Policy andPractice. Summarize the current studies, analyze the current status and problems abouttransitional care in organization and implementation, and propose feasible suggestions forthe development of transitional care in China.Methods:Cochrane Handbook for Systematic Reviews of Interventions was followed. Withstrictly designed search strategies, published literatures were searched through PubMed,ScienceDirect (Elsevier Science), Web of Science (SCI), CNKI, VIP, Wan Fang database.The end search period was restricted to2012. The literatures of randomized controlled trials(RCT) or quasi-RCT on the effectiveness of transitional care were selected. All the studieswere selected according to the inclusion criteria. Reference lists from included studies werealso examined. The Cochrane Handbook was used to assess the quality of those includedstudies. All data were extracted using a data extraction form, and Review Manager5.0software was applied in this review.Results:1. At the second step, six hundred and five articles were found after a thoroughliterature search. There were542articles during2008-2012, accounting for89.6%of thenearly10years’ articles. There were more than30kinds of diseases, such as stroke, diabetes,hypertension, cancer, chronic obstructive pulmonary disease, cardiovascular disease, etc.2. Sixty-five studies were included in this systematic review. Thirty-nine studies wereabout stroke patients and twenty-six studies were about hypertension patients. Most includedstudies were Grade B, respectively24studies and15studies. The largest sample size was342and40studies had more than100participants.3. Transitional care for stroke patients⑴Activities of Daily Living①Barthel Index: at1month, WMD=15.46,95%CI(5.94,24.98), p=0.001; at2months, WMD=17.20,95%CI(13.9 4,20.54), p<0.00001; at3months, WMD=11.82,95%CI(6.89,16.75), p<0.00001; at6months, WMD=20.83,95%CI(6.27,35.39), p=0.005.②MBI: at3months, WMD=13.76,95%CI(9.77,17.74), p<0.00001; at6months, WMD=20.73,95%CI(7.26,34.20), p=0.003; at12months, WMD=7.49,95%CI(3.42,11.56), p=0.0003.⑵Movement Function: at1month,WMD=10.88,95%CI(-4.61,26.36), p=0.17; at3months, WMD=19.94,95%CI(-1.08,40.96),p=0.06; at6months, WMD=15.71,95%CI(8.16,23.26), p<0.0001; at12months,WMD=2.93,95%CI(0.28,5.58), p=0.03.⑶Recurrence of Cerebrovascular Disease: at12months, RR=0.33,95%CI(0.23,0.47), p<0.00001.4. Transitional care for hypertension patients⑴Systolic Blood Pressure: at6months,WMD=-21.11,95%CI(-23.50,-18.73), p<0.00001; at12months, WMD=-28.72,95%CI(-42.19,-15.25), p<0.00001.⑵Diastolic Blood Pressure: at6months, WMD=-11.85,95%CI(-14.48,-9.23), p<0.00001; at12months, WMD=-22.99,95%CI(-37.28,-8.70),p<0.00001.⑶The Rate of Target Blood Pressure: at3months, RR=1.43,95%CI(1.13,1.82),p=0.003; at6months, RR=1.46,95%CI(1.29,1.65), p<0.00001; at12months, RR=1.83,95%CI(1.15,2.93), p=0.01.Conclusions:1. Transitional care has been paid extensive attention. The number of relative studieshas increased obviously since2008. There are more than30kinds of diseases, most ofchronic diseases.2. Sixty-five studies were included in this systematic review. Most included studieswere with middle risk of bias. The sample size of included studies was small and with weakrepresentation compared the existing cases.3. For stroke patients, transitional care could improve their activities of daily living andreduce the recurrence of cerebrovascular disease. There was a long-term effect on movementfunction better than the short-term effect.4. For hypertension patients, transitional care could effectively control their bloodpressure.5. Transitional care is one new nursing model which can adapt to the social andeconomic development need. We should fully utilize the current positive conditions andexert own advantages to develop ourself transitional care model. |
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