Types and Effects of Telenursing in Home Health Care: A Systematic Review and Meta-Analysis.

ABSTRACT

Purpose: This systematic review aimed to identify the types and effectiveness of telenursing in home health care (HHC) compared to conventional HHC. Methods: This study followed the Preferred Reporting Items for Systematic Review and Meta-Analysis 2020 guidelines. A random-effects meta-analysis was performed. The risk of bias was assessed using the Risk of Bias 2.0 tool. The quality of bias was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation system. Results: A total of 17 studies published between 2003 and 2022 were included in the review. The majority of the targeted health conditions of the patients were chronic obstructive pulmonary disease or congestive heart failure (70%). We categorized telenursing interventions according to different technology (N = 4) and nursing (N = 7) types. Among the identified types of nursing, fundamental nursing to monitor patients' symptoms was the most representative. Telemonitoring was found to be the most common technology type, followed by synchronous technology using video or telephone. The telenursing outcomes, including health care utilization, physiological/psychological outcomes, and quality of life, varied. In the meta-analysis, participants who received telenursing reported fewer hospital admissions (standardized mean difference [SMD] -0.18; confidence interval [95% CI] -0.43 to -0.02) and emergency department visits (SMD -0.28; 95% CI -0.45 to -0.10). Conclusion: Telenursing in HHC tends to improve the quality of life and could result in many benefits, including a reduction in health care utilization and facilitating the management of chronic diseases. These results ultimately represent the potential effectiveness of telenursing in community health care settings.