Journal of nursing management · 2026
Effects of Continuous Care on Clinical Outcomes, Psychosocial Well-Being, and Healthcare Utilization in Adults With Enterostomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
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Yang Ru, Shi Zeyao, Li Yingxin, Huang Xi, Li Xia, Chen Xushu, Chen Qiong, Hu Yanling, Li Yuan, Li Xiaowen
Аннотация
AIM: To evaluate the effects of continuous care on clinical outcomes, psychosocial well-being, and healthcare utilization in adults with enterostomy.
BACKGROUND: Adults with enterostomy confront significant physical, psychological, and economic burdens. Continuous care has emerged as a promising intervention facilitating the critical hospital-to-home transition, yet its comprehensive effectiveness requires systematic evaluation.
EVALUATION: MEDLINE, Embase, CENTRAL, and CINAHL were searched from January 2000 to September 2026. Eligible studies were randomized controlled trials evaluating continuous care interventions in adults with enterostomy. The primary outcome was the incidence of stoma-related complications; secondary outcomes included psychosocial well-being (quality of life, self-care ability, self-efficacy, ostomy adjustment, anxiety, depression, and patient satisfaction) and healthcare utilization. Two researchers independently screened literature, extracted data, and assessed risk of bias using RoB 2. Random-effects meta-analyses were conducted in R, and certainty of evidence was assessed using GRADE.
KEY ISSUE(S): Eighteen trials involving 1926 participants were included. Continuous care significantly reduced stoma-related complications (RR = 0.34; 95% CI: 0.26-0.45; I2 = 0%) and improved quality of life (SMD = 1.55; 95% CI: 0.91-2.19; I2 = 93.1%), self-care ability (SMD = 1.57; 95% CI: 0.82-2.32; I2 = 95.3%), and self-efficacy (SMD = 1.29; 95% CI: 0.64-1.94; I2 = 91.9%). Beneficial effects were also observed for ostomy adjustment, anxiety, and depression. Narrative synthesis of three studies suggested fewer unplanned readmissions.
CONCLUSIONS: Continuous care interventions may improve clinical and psychosocial outcomes and reduce unplanned readmissions in adults with enterostomy. However, because several patient-reported outcomes were supported by low or very low certainty evidence and showed substantial heterogeneity, these findings should be interpreted as supportive rather than definitive evidence for early, seamless continuous care models.
IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should consider developing structured hospital-to-home pathways incorporating discharge preparation, self-care readiness assessment, planned follow-up, and access to specialist or multidisciplinary support.
BACKGROUND: Adults with enterostomy confront significant physical, psychological, and economic burdens. Continuous care has emerged as a promising intervention facilitating the critical hospital-to-home transition, yet its comprehensive effectiveness requires systematic evaluation.
EVALUATION: MEDLINE, Embase, CENTRAL, and CINAHL were searched from January 2000 to September 2026. Eligible studies were randomized controlled trials evaluating continuous care interventions in adults with enterostomy. The primary outcome was the incidence of stoma-related complications; secondary outcomes included psychosocial well-being (quality of life, self-care ability, self-efficacy, ostomy adjustment, anxiety, depression, and patient satisfaction) and healthcare utilization. Two researchers independently screened literature, extracted data, and assessed risk of bias using RoB 2. Random-effects meta-analyses were conducted in R, and certainty of evidence was assessed using GRADE.
KEY ISSUE(S): Eighteen trials involving 1926 participants were included. Continuous care significantly reduced stoma-related complications (RR = 0.34; 95% CI: 0.26-0.45; I2 = 0%) and improved quality of life (SMD = 1.55; 95% CI: 0.91-2.19; I2 = 93.1%), self-care ability (SMD = 1.57; 95% CI: 0.82-2.32; I2 = 95.3%), and self-efficacy (SMD = 1.29; 95% CI: 0.64-1.94; I2 = 91.9%). Beneficial effects were also observed for ostomy adjustment, anxiety, and depression. Narrative synthesis of three studies suggested fewer unplanned readmissions.
CONCLUSIONS: Continuous care interventions may improve clinical and psychosocial outcomes and reduce unplanned readmissions in adults with enterostomy. However, because several patient-reported outcomes were supported by low or very low certainty evidence and showed substantial heterogeneity, these findings should be interpreted as supportive rather than definitive evidence for early, seamless continuous care models.
IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should consider developing structured hospital-to-home pathways incorporating discharge preparation, self-care readiness assessment, planned follow-up, and access to specialist or multidisciplinary support.