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Nurse-led telephone-based follow-up interventions play a role in patient follow-up, but at present, no meta-analysis has been found to assess the effectiveness of nurse-led, telephone follow-up interventions for patients with acute coronary syndrome.
This systematic review and meta-analysis aimed to evaluate the effectiveness of nurse-led telephone-based follow-up interventions on health outcomes in people with acute coronary syndromes.
Systematic review and meta-analysis of randomized controlled trials.
A comprehensive search of six databases: PubMed, Web of Science, Embase, Cochrane Library, CINAHL and Scopus was conducted from the inception of the databases to 30 September 2023. The Cochrane Risk of Bias Tool was used to assess the methodological quality of the included randomized controlled studies. Review Manager 5.4 and Stata 16.0 were used to conduct statistical analysis.
A total of 12 studies were included. Nurse-led telephone-based follow-up interventions may reduce systolic and diastolic blood pressure (MD = −2.55, 95% CI [−4.16, −0.94]) (MD = −2.15, 95% CI [−3.18, −1.12]) and low-density lipoprotein (MD = −9.06, 95% CI [−14.33, −3.79]) in patients with acute coronary syndrome. However, its effectiveness in controlling high-density lipoprotein (MD = 1.65, 95% CI [−4.30, 7.61]) and reducing total cholesterol (MD = −2.72, 95% CI [−7.57, 2.13]) was uncertain. In addition, the results showed that the nurse-led follow-up intervention did not play a role in improving anxiety (SMD = −0.20, 95% CI [−0.44, 0.04]) and depression (SMD = −0.07, 95% CI [−0.21, 0.06]) in patients with acute coronary syndrome, but it probably improved drug adherence (RR = 1.30, 95% CI [1.05, 1.60]) and smoking cessation (RR = 1.31, 95% CI [1.08, 1.60]).
The findings of this review suggest that nurse-led telephone-based follow-up interventions had a potentially positive effect on controlling blood pressure and low-density lipoprotein levels, as well as improving medication adherence and smoking cessation among patients with acute coronary syndrome, compared to usual care. However, the intervention did not appear to significantly impact high-density lipoprotein, total cholesterol, anxiety, and depression, indicating that further research in these areas will be necessary in the future.
PROSPERO (International Prospective Register of Systematic Reviews): CRD42023465894
To explore the network characteristics of symptom clusters in people with type 2 diabetes mellitus through network analysis, identify the core and bridging symptoms within the symptom network, and provide a foundation for targeted interventions and symptom management in people with T2DM.
A cross-sectional survey.
A total of 360 people with T2DM who were hospitalised in the endocrinology departments of two hospitals with Grade A in Daqing City between August 2024 and February 2025 were selected using a convenience sampling method. The symptoms of people with T2DM were measured using the Chinese version of the Diabetes Symptom Checklist-Revised (DSC-R). Symptom clusters were identified through factor analysis, and network analysis was used to identify core and bridging symptoms. This research adhered to the STROBE guidelines.
Six symptom clusters were obtained from factor analysis, which were psychological-behavioural symptom cluster, ophthalmological-neuropathy symptom cluster, cardiovascular symptom cluster, metabolic symptom cluster, body symptom cluster and nephrotic symptom cluster. Symptom network analysis revealed that ‘Deteriorating vision’ exhibited the highest strength centrality and expected influence. The top three symptoms with the highest bridge strength and bridge expected influence were ‘Aching calves when walking’, ‘Queer feeling in the legs or feet’ and ‘Sleepiness or drowsiness’.
People with T2DM commonly exhibit a range of symptoms. ‘Deteriorating vision’ is the most core symptom in people with T2DM. ‘Aching calves when walking’, ‘Queer feeling in the legs or feet’ and ‘Sleepiness or drowsiness’ are identified as the bridging symptoms in the network analysis. Healthcare professionals can design targeted interventions based on symptom clusters, core symptoms and bridging symptoms, thereby improving the efficiency of symptom management and optimising outcomes for people with T2DM.
No patient or public contribution.
To develop and validate a tool to estimate the risk of central venous catheter-related thrombosis (CRT) in children with congenital heart disease.
Children with congenital heart disease face an elevated risk of CRT, which is closely linked to adverse clinical outcomes. Early detection of CRT may improve prognosis and reduce mortality. However, no specific tools currently exist to effectively assess it.
A cross-sectional study.
From January 2020 to April 2023, we enrolled 503 children with congenital heart disease. Four hundred and three were assigned to the modelling cohort and 100 to the validation cohort. Using binary logistic regression, a predictive model was constructed, followed by the development of a dynamic online nomogram. The model's internal and external verification were performed using ROC analysis, the Hosmer–Lemeshow test, and decision curve analysis, respectively. The study adhered to the TRIPOD guidelines.
The prevalence of CRT in the modelling cohort and validation cohort was 23.57% and 21.00%, respectively. Logistic regression analysis identified duration of catheterization, length of ICU stay, duration of sedation, fibrinogen ≥ 4 g/L and platelet count ≥ 400 × 109/L as independent predictive factors for CRT, all of which were incorporated into the nomogram. The nomogram achieved an AUC of 0.866 in the modelling cohort and 0.761 in the validation cohort, demonstrating strong discriminatory power. In both cohorts, the calibration curve indicated good agreement and decision curve analysis confirmed its significant clinical utility.
We developed a dynamic online nomogram that demonstrated strong predictive accuracy and was practical for identifying CRT in children with congenital heart disease.
This nomogram enables healthcare providers to estimate the risk of CRT in children with congenital heart disease, offering an effective tool for risk stratification and a basis for implementing targeted interventions.
No patient or public contribution.
To develop and validate a behavioural driving model for adherence to home-based cardiac rehabilitation exercise in patients with chronic heart failure, and to explain the potential driving mechanism of social support on exercise adherence.
Despite the benefits of home-based cardiac rehabilitation exercise, adherence among patients with chronic heart failure remains suboptimal. Several factors contributing to adherence have been confirmed; however, the specific pathway mechanisms by which these factors impact exercise adherence have not been thoroughly explored.
An exploratory sequential mixed-methods study was conducted in this study.
A total of 226 patients with chronic heart failure were recruited using convenience sampling. Quantitative data were collected using a series of self-report questionnaires. Hierarchical regression analysis was performed to verify multiple pathways. Subsequently, 12 patients with chronic heart failure were drawn from the quantitative stage. The interview data were thematically analysed. This study followed the Good Reporting of a Mixed Methods Study (GRAMMS) guidelines (Appendix S1).
Perceived social support had a direct positive predictive effect on exercise adherence. Importantly, exercise self-efficacy and exercise fear played a chain-mediating role between perceived social support and exercise adherence. As a result of the qualitative phase, scale, tightness and homogeneity of social support networks emerged as potential drivers of the effectiveness of social support on exercise adherence.
This study reveals a potential pathway mechanism for social support to improve adherence to home-based cardiac rehabilitation exercises. Social support network plays a crucial role in the effect of social support on exercise adherence.
To enhance exercise adherence in home-based cardiac rehabilitation for patients with chronic heart failure, establishing a social support network is recommended. This strategy has the potential to promote exercise self-efficacy and alleviate exercise fear.
None.
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