Comparison of the Effects of Nurse-led Interventions and Nurse-involved Multidisciplinary Interventions for Early Mobilization in Critically Ill Patients : A Systematic Review and Meta-analysis
중환자 조기이동을 위한 간호사 주도형 중재와 간호사 참여형 다학제 중재의 효과 비교 : 체계적 문헌고찰 및 메타분석
Early mobilization in intensive care improves patient recovery, yet the comparative effects of nurse-led and nurse-involved approaches remain unclear. This study aimed to compare their effects on clinical outcomes in critically ill patients. A systematic review and meta-analysis was conducted. PubMed, Embase, CINAHL, and the Cochrane Library were searched using the keywords ‘critically ill patients’, ‘early mobilization’, ‘nurse-led’, ‘nurse involvement’, and ‘interventions’. Thirteen studies were included (7 nurse-led; 6 nurse-involved multidisciplinary interventions). Nurse-led interventions were favorably associated with reduced hospital stay (MD -4.68 days) and improved muscle strength (MD 10.90) in non-randomized studies. Nurse-involved multidisciplinary interventions more consistently reduced ventilator duration (RCT: MD -2.29 days; non-RCT: MD -5.25 days). Both approaches may support recovery in critically ill patients, but clearer nursing roles and standardized intervention components are needed for consistent implementation.
한국어
중환자실에서의 조기이동은 환자 회복을 촉진하는 중요한 전략이나, 간호사 주도형과 간호사 참여형 다학 제 중재의 비교 효과는 명확히 규명되지 않았다. 본 연구는 중환자 조기이동을 위한 두 중재의 임상적 효과를 비 교하고자 수행된 체계적 문헌고찰 및 메타분석이다. PubMed, Embase, CINAHL, Cochrane Library를 활용하여 ‘중환자’, ‘조기이동’, ‘간호사 주도’, ‘간호사 참여’, ‘중재’를 주제어로 문헌을 검색하였다. 총 13편의 연구(간호사 주 도형 7편, 간호사 참여형 다학제팀 중재 6편)를 분석하였다. 간호사 주도형 조기운동은 비무작위 연구에서 병원 재원일수 감소(MD –4.68 days)와 근력 향상(MD 10.90)에서 긍정적 경향을 보였고, 간호사 참여형 다학제 중재 는 인공호흡기 사용기간 단축(RCT: MD -2.29 days; non-RCT: MD -5.25 days)에서 일관된 효과를 보였다. 이 상의 결과에서 간호사 주도형 및 참여형 조기운동 중재는 중환자의 회복에 기여할 수 있으나, 향후 중환자 재활에 서 간호사의 역할과 중재 구성 요소를 명확히 규정하고 일관된 실행 체계를 마련할 필요가 있겠다.
목차
Abstract 요약 Ⅰ. Introduction Ⅱ. Methods 2.1 Study Design 2.2 Search Strategy 2.3 Eligibility Criteria 2.4 Study selection and Data Extraction 2.5 Quality Appraisal 2.6 Data Synthesis and Statistical Analysis Ⅲ. Results 3.1 Study Selection 3.2 Study Characteristics 3.3 Early mobilization components 3.4 Quality assessment and certainty of the evidence 3.5 Outcomes Ⅳ. Discussion Ⅴ. Conclusion REFERENCES [Supplementary]
키워드
중환자실조기이동간호재원일수메타분석Intensive Care UnitsEarly AmbulationNursing CareLength of StayMeta-Analysis
저자
Yerin Baek [ 백예린 | RN, Department of Nursing, Dong-A University Hospital ]
Jungmi Yun [ 윤정미 | Associate professor, College of Nursing, Research Institute of Nursing Science, Pusan National University ]
Corresponding Author
Ever since next generation convergence technology became one of the most important industries in the nation, computing professionals have encountered a growing number of challenges. Along with scholars and colleagues in related fields, they have gathered in avariety of forums and meetings over the last few decades to share their knowledge, experiences and the outcome of their research. These exchanges have led to the founding of the International Next-generation Convergence technology (INCA) on December 1, 2015. INCA was registered as an incorporated association under the Ministry of Information and Communications. The main purpose of the organization is to improve our society by achieving the highest capability possible in next generation convergence technology.
간행물
간행물명
차세대융합기술학회논문지 [The Journal of Next-generation Convergence Technology Association]