Nursing sensitive outcomes in patients with rheumatoid arthritis: A systematic literature review

van Eijk Hustings, Yvonne; Minnock, Patricia; McKee, Gabrielle; Kelly, Alexia; Carter, Sheree C; Menzies, Victoria; O'Sullivan, Denis; Richards, Pam; Ndosi, Mwidimi

Abstract

© 2017 Elsevier Ltd Background Although rheumatology nursing has been shown to be effective in managing patients with rheumatoid arthritis, patient outcomes sensitive to nursing interventions (nursing sensitive outcomes) have not been systematically studied. Objectives The objective of this study was to identify and delineate relevant patient outcomes measured in studies that reported nursing interventions in patients with rheumatoid arthritis. Design A systematic search was conducted from 1990 to 2016. Inclusion criteria were (i) patients with rheumatoid arthritis, (ii) adult population age ≥16 years, (iii) nurse as part of the care team or intervention delivery, (iv) primary research only, (v) English language, and (vi) quantitative studies with nursing sensitive outcomes. Data sources Medline, CINAHL, Ovid nursing, Cochrane library and PsycINFO databases were searched for relevant studies. Review methods Using the predetermined inclusion/exclusion criteria, nine reviewers working in pairs assessed the eligibility of the identified studies based on titles and abstracts. Papers meeting the inclusion criteria were retrieved and full texts were further assessed. Critical Appraisal Skills Programme tools were used to assess the quality of the included studies. Data on nursing sensitive outcomes were extracted independently by two reviewers. The Outcome Measures in Rheumatology comprehensive conceptual framework for health was used to contextualise and present findings. Results Of the 820 articles retrieved, 7 randomised controlled trials and 3 observational studies met the inclusion criteria. Seventeen nursing sensitive outcomes were identified (disease activity, clinical effects, pain, early morning stiffness duration, fatigue, patient safety issues, function, knowledge, patient satisfaction, confidence in care received, mental health status, self-efficacy, patient attitude/perception of ability to control arthritis, quality of life, health utility, health care resources, death). These fitted into 10 health intervention domains in keeping with the pre-specified conceptual framework for health: disease status, effectiveness, safety, function, knowledge, satisfaction, psychological status, quality of life, cost, death. A total of 59 measurement instruments were identified comprising patient reported outcome measures (n = 31), and biologic measures and reports (n = 28). Conclusions This review is notable in that it is the first to have identified, and reported, a set of multidimensional outcome measures that are sensitive to nursing interventions in rheumatology specifically. Further research is required to determine a core set of outcomes to be used in all rheumatology nursing intervention studies.

• Journal Article Type: Article
• Acceptance Date: Sep 9, 2017
• Online Publication Date: Sep 12, 2017
• Publication Date: Jan 1, 2018
• Deposit Date: Sep 13, 2017
• Publicly Available Date: Sep 12, 2018
• Journal: International Journal of Nursing Studies
• Print ISSN: 0020-7489
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 77
• Pages: 115-129
• DOI: https://doi.org/10.1016/j.ijnurstu.2017.09.005
• Keywords: nursing outcomes, OMERACT, outcome measurement, patient reported outcomes, rheumatoid arthritis, systematic review
• Public URL: https://uwe-repository.worktribe.com/output/872174
• Publisher URL: http://dx.doi.org/10.1016/j.ijnurstu.2017.09.005
• Related Public URLs: https://doi.org/10.1016/j.ijnurstu.2017.09.005 /> http://www.sciencedirect.com/science/article/pii/S0020748917302122
• Additional Information: Additional Information : Published first online 13th Sep 2017
• Contract Date: Sep 13, 2017