Effects of continuous care on health outcomes in patients with stoma: A systematic review and meta-analysis

Identifier:  imarina:9261802

Handle: https://hdl.handle.net/20.500.11797/imarina9261802

Authors:  Jin, Yanfei; Tian, Xu; Li, Yufeng; Jimenez-Herrera, Maria; Wang, Honghong

Abstract:
Objective: Continuing care, which is an extension of post-discharge care, is recognized as a crucial element of high-quality health services and is essential to patients. This systematic review aims to identify the effectiveness of continuing care for patients with stomas. Methods: PubMed, EMBASE, Cochrane Trial Register and Web of Science databases were searched. Study selection and quality appraisal were performed independently by two reviewers. We calculated the mean differences (MD) or the relative risk (RR) with 95% confidence intervals and assessed heterogeneity. Results: Nine studies (1134 participants) met the inclusion criteria. This meta-analysis revealed that, in the continuous care group, the stoma self-efficacy (MD ​= ​6.46; 95% CI ​= ​3.81–9.11; P ​< ​0.001; I2 ​= ​0%), and the quality of life (MD ​= ​7.48; 95% CI ​= ​5.13–9.82; P ​< ​0.001; I2 ​= ​0%) increased significantly 1 month after discharge; stoma adjustment and care satisfaction also showed a trend toward improvement while stoma complications (RR ​= ​0.71; 95% CI ​= ​0.58–0.87; P ​= ​0.001; I2 ​= ​25%) decreased significantly. Continuing care did not decrease hospital readmission rates or medical costs. Conclusions: Continuing care showed beneficial effects in improving health outcomes and care satisfaction for patients with stomas compared with routine care. We proposed an integrated continuing care program with different elements and recommendations for its implementation.