Effectiveness of interventions involving nurses in secondary stroke prevention: A systematic review and meta-analysis. (December 2018)

• Record Type: Journal Article
• Authors: Parappilly, Beena P; Field, Thalia S; Mortenson, William B; Sakakibara, Brodie M; Eng, Janice J
• Is Part Of: European journal of cardiovascular nursing. Volume 17:Number 8(2018)
• Page Start: 728
• Page End: 736
• Publication Date: 2018-12
• Subjects: Stroke -- secondary prevention -- nursing; Cardiovascular system -- Diseases -- Nursing -- Periodicals; Cardiovascular Diseases -- nursing -- Periodicals; Cardiology -- Periodicals; Nursing -- Periodicals; Vascular Diseases -- Periodicals; 610.7369105
• DOI: 10.1177/1474515118779732
• Languages: English
• ISSNs: 1474-5151

Abstract

Background and purpose: Among members of the health care team, nurses play a large role in actively engaging stroke survivors in secondary stroke prevention programs. This systematic review and meta-analysis examines the effectiveness of interventions in which nurses have a primary role on modification of risk factors among stroke survivors. Methods: We systematically searched for randomized controlled trials in relevant databases investigating the role of nurses in secondary stroke prevention. Meta-analyses were conducted using Cochrane Review Manager Software. The mean pooled effect size, a 95% confidence interval (CI), and I -squared ( I 2 ) for heterogeneity were calculated. Results: Sixteen randomized controlled trials were included with a total of 3568 stroke and transient ischemic attack patients. After removing one outlier, the models demonstrated a statistically significant effect on reducing systolic blood pressure (SMD = −0.14 (95% CI = −0.23, –0.05), I 2 = 0%; p = 0.002, six studies, n =1885) and diastolic blood pressure (SMD = −0.16 (95% CI = −0.27, –0.05), I 2 = 0%; p = 0.003, four studies, n =1316). The interventions also significantly improved physical activity (five studies, n =1234), diet (three studies, n =425), medication adherence (two studies, n =270), and knowledge of risk factors (three studies, n =516). However, there was no effect on smoking cessation or reduction in use of alcohol. Conclusion: We found that interventions in which nurses had a primary role were effective on improving medical and behavioral risk factors, as well as knowledge of risk factors as part of secondary prevention of stroke.