Abstract
BACKGROUND: Chronic respiratory diseases present significant challenges for healthcare management, necessitating effective communication and planning for future care. Nurse-led advance care planning (ACP) interventions aim to improve patient outcomes by facilitating discussions about care preferences and treatment choices. This meta-analysis evaluates the effectiveness of nurse-led ACP interventions on various outcomes in patients with chronic respiratory diseases. METHODS: Comprehensive search was conducted across PubMed, Embase, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and Google Scholar up to May 2024. Randomised controlled trials and non-randomised trials assessing the impact of nurse-led ACP interventions were included. Pooled standardised mean differences (SMD) and odds ratios (OR) were calculated using a random-effects model, with heterogeneity assessed via I(2) and τ(2) statistics. RESULTS: For quality of life, pooled SMD was 0.073 (95% CI: -0.372 to 0.517), indicating negligible effect. Quality of communication showed pooled SMD of 2.137 (95% CI: -0.343 to 4.616). Anxiety had pooled SMD of -0.166 (95% CI: -0.628 to 0.296). Depression scores increased slightly (SMD = 0.756; 95% CI: -0.987 to 2.499). Hospital admissions (SMD = 0.127; 95% CI: -0.085 to 0.338) and length of hospital stay (SMD = 0.145; 95% CI: -0.091 to 0.382) both showed minimal effects with low heterogeneity. Discussions with physicians about treatment choices had OR of 1.773 (95% CI: 0.899 to 3.497), indicating positive but nonsignificant increase. Completion of advanced directives showed OR of 1.856 (95% CI: 0.999-3.488). CONCLUSION: Nurse-led ACP interventions have a significant impact on the quality of communication between patients and healthcare providers, though their effect on the quality of life and other clinical outcomes is less pronounced.