Outcomes of nurse-led telecoaching intervention for patients with heart failure: A systematic review and meta-analysis of randomised controlled trials.

BACKGROUND: Studies have identified that nurse-led telephone health coaching benefited the continuity of care in patients with heart failure. However, the effect of nurse-led telephone health coaching remains inconclusive among the previous studies. AIM: This review aimed to determine the effects of nurse-led telecoaching among patients with heart failure. DESIGN: This study was a systematic review and meta-analysis of randomised controlled trials. This study was reported in accordance with the PRISMA guideline. METHODS: Seven databases (PubMed, Embase, CINAHL, Web of Science, MEDLINE, Cochrane library and Ovid) were electronically searched up to 20 October 2020. The eligibility criteria were a randomised controlled trial study on heart failure patients, with the intervention led by a nurse through telephone coaching. Two authors independently evaluated the methodological quality using the modified Jadad scale. The Comprehensive Meta-Analysis software version 3.0 with a random effect model was used to conduct a meta-analysis, and Begg's and Egger's tests were performed to assess publication bias. Furthermore, sensitivity analysis was carried out. RESULTS: A total of 12 randomised controlled trials were met eligibility criteria and representing 1938 heart failure patients. The results showed that the nurse-led telecoaching significantly enhanced patients' self-care behaviour (SMD = .84, 95%CI [0.45-1.24], p < .001) and improved quality of life (SMD = .23, 95%CI [0.06-0.39], p = .007). CONCLUSION: Nurse-led telecoaching appears to enhance self-care behaviour and improve quality of life in patients with heart failure. Further research needs to build the evidence for nurse-led telecoaching intervention, including understanding its mechanisms of action (e.g. frequency, components) and identifying its moderating factors. RELEVANCE TO CLINICAL PRACTICE: Implementation of nurse-led telecoaching is deemed helpful in promoting continuity of care because it was an accessible and sustainable intervention to improve patients' self-care and quality of life.

Determinants of fear of falling in older adults with diabetes.

OBJECTIVES: To identify the important determinants of FoF among older adults with diabetes in endocrine clinics based on demographic and illness characteristics, physical function and capability, psychosocial and cognitive factors. METHODS: A cross-sectional study was conducted on 240 older adults with Type 2 diabetes who were recruited by convenience sampling. Self-reported questionnaires, medical records as well as physical function and capability tests were used to collect the data. Multiple linear regression was used to identify the important determinants of FoF. RESULT: Diabetes distress, sarcopenia levels, TUG results, and HbA1c levels were significant determinants of FoF. These determinants uniquely explained 14%, 9%, 4%, and 2% of the variance in FoF respectively. CONCLUSION: Beside sarcopenia and dynamic balance being known as significantly associated with FoF in a general older population, diabetes distress and HbA1c levels should also be considered in designing interventions to improve FoF among older adults with diabetes.