Non-pharmacological nursing interventions in patients with myocardial infarction: a systematic review

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Background: Multiple interventions have been implemented with varying degrees of effectiveness. A comprehensive analysis is necessary to evaluate and characterize the efficacy of each intervention. This study aimed to examine the impact of non-pharmacological nursing interventions on patients with myocardial infarction. Methods: A literature search was conducted across five databases: Scopus, PubMed, Web of Science, Embase, and MEDLINE. Each database was last searched on May 13, 2024. The PICO (population, intervention, comparator, and outcome) approach was used to create a comprehensive and well-structured research question. The quality of the studies included was assessed using the critical appraisal tools from the Joanna Briggs Institute (JBI). Results: This review included 52 studies. A total of eighteen distinct non-pharmacological interventions were assessed to evaluate their efficacy in improving outcomes for patients with myocardial infarction. The findings of this review highlight that various types of nursing interventions can, to some extent, impact patient outcomes. Regarding intervention types, telephone follow-up/remote management were used in 8 studies; psychological interventions in 8 studies; nursing care pathways in 8 studies; rehabilitation nursing care in 4 studies; home-care nursing in 4 studies; exercise nursing care and evidence-based nursing in 3 studies each; nurse-led individualized self-management program, educational interventions, and targeted nursing care in 2 studies each; and structured team nursing model, whole-course nursing care, acupressure, spiritual nursing care, systematic nursing care, high-quality nursing, ice bag application, and music intervention were each reported in 1 study. Regarding outcome types, death/complications/readmission were investigated in 16 studies; quality of life (QOL) in 12 studies; cardiac function in 14 studies; anxiety/depression/stress in 6 studies; adherence in 2 studies; and pain in 2 studies. The studies were predominantly limited in scale and demonstrated substantial variability in the types of interventions implemented as well as in the outcomes assessed. Furthermore, most of the included studies were rated as moderate to low quality. Conclusions: The findings of this review highlight that non-pharmacological nursing interventions can, to some extent, impact patient outcomes. However, due to the methodological constraints, the results should be interpreted with prudence. Further investigation employing larger sample sizes and improved methodological rigor is necessary to more conclusively ascertain the effectiveness of these nursing interventions.

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