Specialist nursing interventions for inflammatory bowel disease

  • Review
  • Intervention




The number, type and roles of specialist nurses dedicated to the care and management of patients with inflammatory bowel disease is increasing. Despite this increase, there has been little evidence to date to demonstrate the effectiveness of specialist nursing interventions. This review aims to identify and evaluate the impact of specialist nursing interventions on management of inflammatory bowel disease, access to treatment, remission, morbidity and quality of life.


To identify and evaluate the impact of specialist nursing interventions for improving the care and management of patients with inflammatory bowel disease (IBD).

Search methods

A comprehensive search of databases including the Cochrane Library, MEDLINE, and British Nursing Index was carried out to identify trials. References from relevant papers were searched and hand searching was undertaken of relevant publications including gastroenterology conference proceedings to identify additional trials (date of last search 30 September 2008).

Selection criteria

Randomised controlled trials, controlled before and after studies and interrupted time series studies of gastroenterology and IBD specialist nurses intending to improve access and outcomes for patients with ulcerative colitis and Crohn's disease were considered for inclusion.

Data collection and analysis

Two investigators independently extracted data and assessed trial quality. Any discrepancies were resolved by consensus.

Main results

One randomised controlled trial of 100 IBD patients receiving a specialist nurse delivered counselling package (n = 50) or routine outpatient clinic follow-up (n = 50), with assessments at entry and six and 12 months, was included in this review. This study was of low methodological quality. Disease remission, patient compliance, clinical improvement, utilisation of nurse-led services, patient satisfaction, hospital admission, outpatient attendance, progression to surgery, length of hospital stay and cost effectiveness data were not reported. Pooled mean mental health scores at 6 months were higher in patients who received nurse-led counselling compared to patients who received routine follow-up. However, this difference was not statistically significant (WMD 3.67; 95% CI -0.44 to 7.77; P = 0.08). Other pooled assessments of physical and psychological well-being showed no statistically significant differences.

Authors' conclusions

Although specialist nurse counselling interventions might provide benefit for IBD patients the one included study was of low quality and the results of this study should be interpreted with caution. Higher quality trials of gastroenterology and IBD specialist nursing interventions are needed to assess the impact of specialist nursing interventions on the care and management of patients with inflammatory bowel disease.








針對資料庫全面搜尋,包括Cochrane Library、MEDLINE和British Nursing Index等,以找出相關試驗。搜尋出相關研究的參考資料,並翻閱相關出版品,包括腸胃病學會議的會議記錄,以找出更多的試驗(最後搜尋日期為2008年9月30日)。






一項有100位炎症性腸病患者接受一位專科護士於研究開始、6個月和12個月時到府諮商服務(n = 50)或固定門診追蹤及評估(n = 50)的隨機對照試驗,納入此回顧研究。此項研究的研究方法品質較差。關於疾病的緩解、患者的遵囑性、臨床症狀的改善、護士到府服務的利用、患者的滿意度、住院人數、門診病人的到診率、手術進展、住院期及成本效率等數據資料皆無報導。在6個月後,接受護士到府服務的患者,其心理健康的平均分數比接受固定追蹤患者的分數高。不過差異並無統計上的意義(WMD 3.67; 95% CI 0.44 −.77; P = 0.08)。而身體上和心理學上的評估也無統計上的明顯差異。




此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。










試験を同定するために、コクラン・ライブラリ、MEDLINE、およびBritish Nursing Indexを含むデータベースの包括的検索を行った。その後追加された試験を同定するために、関連性のある論文からの参考文献を検索し、消化器病学会の予稿集を含む関連性のある出版物をハンドサーチした(最新検索日2008年9月30日)。






専門看護師が行うカウンセリング・パッケージ(n=50)または通常の外来診療部でフォローアップ(n=50)を受けているIBD患者100例を対象に、登録時、6ヵ月および12ヵ月時点で評価していた1件のランダム化比較試験を本レビューに含めた。この研究は、方法論の質が低かった。疾患の寛解、患者のコンプライアンス、臨床的改善、看護師が主導するサービスの利用、患者満足度、入院、外来受診、手術に進行、在院期間および費用対効果のデータは報告されていなかった。統合した6ヵ月時点のメンタルヘルス・スコアの平均は、看護師主導のカウンセリングを受けた患者の方がルーチンのフォローアップを受けた患者よりも高かった。しかし、この差は統計学的に有意ではなかった(重み付け平均差3.67、95%CI -0.44~7.77、P=0.08)。統合したその他の身体的および心理的な健康状態の評価は、統計学的に有意な差を認めなかった。




監  訳: 柴田 実,2010.2.10

実施組織: 厚生労働省委託事業によりMindsが実施した。

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Plain language summary

Specialist nurse counselling interventions for patients with inflammatory bowel disease

The number and type of gastroenterology and inflammatory bowel disease specialist nurses is increasing, along with the variety of roles performed in patient care and management. This review included one low quality trial of a specialist nurse counselling intervention compared with routine outpatient clinic follow up. No data were reported on remission outcomes. Counselling by a specialist nurse might improve mental health related quality of life for some IBD patients in the short term. However, the poor quality of the one included study does not allow for any definitive conclusions regarding the impact of the nurse-led counselling program. Better designed studies are needed to assess the impact of specialist nursing interventions on the care and management of patients with inflammatory bowel disease.

Laički sažetak

Savjetovanje specijalizirane medicinske sestre za pacijente s upalnom bolesti crijeva

Broj i vrsta sestara specijaliziranih za probavne bolesti i upalne bolesti crijeva se povećava, zajedno sa različitim ulogama koje obavlja u srbi za bolesnikova i liječenju. Ovaj Cochrane sustavni pregled uključuje jedno ispitivanje loše kvaliteteu kojem je istražena intervencija specijalizirane medicinske sestre savjetnika u odnosu na rutinsku ambulantnu kliničku praksu. Nisu prikazani podatci o rezultatima remisije. Savjetovanje medicinske sestre može poboljšati kvalitetu života povezanu s duševnim zdravljem kod nekih pacijenata s upalnom bolesti crijeva u kratkom roku. No, loša kvaliteta jednog uključenog ispitivanja ne dozvoljava nikakve definitivne zaključke u pogledu utjecaja programa medicinske sestre savjetnika. Potrebne su bolje provedene studije za procjenu utjecaja specijalnih sestrinskih intervencija na njegu i liječenje pacijenata s upalnim crijevnim bolestima.

Bilješke prijevoda

Cochrane Hrvatska
Prevela: Božena Armanda
Ovaj sažetak preveden je u okviru volonterskog projekta prevođenja Cochrane sažetaka. Uključite se u projekt i pomozite nam u prevođenju brojnih preostalih Cochrane sažetaka koji su još uvijek dostupni samo na engleskom jeziku. Kontakt: cochrane_croatia@mefst.hr