Effects of Continuing Professional Development on Nurses’ Competence in Chronic Illness Care: A Systematic Review and Meta-Analysis
DOI:
https://doi.org/10.30829/contagion.v8i1.25945Abstract
Chronic illnesses, including diabetes mellitus, hypertension, cardiovascular disease, and cancer, represent major global health challenges requiring sustained nursing competence. Continuing Professional Development (CPD) is promoted to enhance nurses’ knowledge, skills, and professional attitudes; however, its effectiveness in chronic illness care remains inconsistent. This meta-analysis evaluated the impact of CPD on nursing competence in managing chronic illnesses. A systematic search of PubMed, Scopus, CINAHL, and Web of Science was conducted for studies published between January 2019 and January 2025. Eligible studies included randomized controlled trials, quasi-experimental, and cohort designs reporting competence-related outcomes following CPD interventions. Data were synthesized using a random-effects model, and heterogeneity was assessed using the I² statistic. Eleven studies involving 1,362 nurses from Asia, Europe, and the Americas met the inclusion criteria. CPD showed a significant positive effect on nursing competence in chronic illness care (Hedges’ g = 0.47; 95% CI: 0.31–0.63; p < 0.001). E-learning and blended learning approaches were more effective than traditional face-to-face methods, and programs lasting more than six months produced greater improvements. Moderate heterogeneity was observed (I² = 48%), with no evidence of publication bias. The findings indicate that CPD moderately improves nursing competence, particularly when delivered through technology-enhanced and sustained educational strategies. Variations in intervention duration and learning modality may explain differences in effect sizes across studies. CPD is an effective strategy to strengthen nursing competence in chronic illness care, especially when implemented through blended or e-learning formats and extended program duration Keywords: Continuing Professional Development, Nursing, Competence, Chronic Illness Care, Meta-AnalysisReferences
Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., & Sermeus, W. (2023). Nurse Staffing and Education and Hospital Mortality: Updated Evidence From European Hospitals. The Lancet Regional Health – Europe, 29, 100624, 225-245, https://doi.org/10.1016/j.lanepe.2023.100624.
American Nurses Association. (2021). Nursing: Scope and Standards Of Practice (4th ed.). ANA Publishing.
Bodenheimer, T., Wagner, E. H., & Grumbach, K. (2023). Improving Primary Care For Patients With Chronic Illness: Revisiting The Chronic Care Model. BMJ, 381, e072901, 1775-1779, https://doi.org/10.1136/bmj-2022-072901.
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2021). Introduction to Meta-Analysis (2nd ed.). Wiley. https://doi.org/10.1002/9781119558378.
Filipe, H. P., Silva, E. D., & Golnik, K. C. (2023). Continuing Professional Development: Trends And Best Practices In Healthcare. Medical Teacher, 45(4), 345–352. https://doi.org/10.1080/0142159X.2023.2173456.
GBD 2023 Diseases and Injuries Collaborators. (2024). Global Burden Of 369 Diseases And Injuries In 204 Countries And Territories, 1990–2023. The Lancet, 403(10440), 2100–2150. https://doi.org/10.1016/S0140-6736(24)00432-1.
George, P. P., Papachristou, N., Belisario, J. M., et al. (2023). Digital Learning In Health Professions Education: Updated Systematic Review. Journal of Global Health, 13, 04045. 55-69. https://doi.org/10.7189/jogh.13.04045.
Haidich, A. B. (2023). Meta-Analysis In Medical Research: Current Methodological Advances. Journal of Clinical Epidemiology, 156, 12–20. https://doi.org/10.1016/j.jclinepi.2023.01.005.
Higgins, J. P. T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., & Welch, V. A. (2022). Cochrane Handbook For Systematic Reviews Of Interventions (Version 6.3). Wiley. https://doi.org/10.1002/9781119536604.
Illing, J., Taylor, G., Howe, A., & Morrow, G. (2023). Continuing Professional Development For Medical Professionals: An Updated Scoping Review. Medical Education, 57(8), 812–824. https://doi.org/10.1111/medu.15092.
International Council of Nurses. (2024). The Global Nursing Workforce Report 2024. ICN.
Jackson, D., Hickman, L., Power, T., Disler, R., Potgieter, I., Deek, H., & Davidson, P. M. (2023). Continuing Professional Development In Nursing: An Updated Integrative Review. Journal of Advanced Nursing, 79(6), 2012–2025. https://doi.org/10.1111/jan.15590.
Kerkez, M., & Öztürk, M. H. (2025). The Effect Of Nurses’ Holistic Competence In Chronic Disease Management On Caregiver Role Attitudes. Journal of Holistic Nursing, 43(2), 112–120. https://doi.org/10.1177/08980101231217374.
King, R., Edlund, B. J., & Spector, N. (2023). Continuing Professional Development: The Role Of Nursing Regulation In Competency Assurance. Journal of Nursing Regulation, 14(1), 22–30. https://doi.org/10.1016/S2155-8256(23)00015-4.
Manley, K., & Jackson, C. (2024). The Importance Of Continuing Professional Development To Nursing Practice. Nursing Standard, 39(2), 45–50. https://doi.org/10.7748/ns.2024.e12130.
Manley, K., & Jackson, C. (2022). The Importance of Continuing Professional Development To Nursing Practice. Nursing Standard, 37(2), 45–50. https://doi.org/10.7748/ns.2022.e11947.
Manojlovich, M. (2023). Nursing Leadership, Professional Practice Environments, And Nurse Outcomes: Contemporary Evidence And Implications. Journal of Nursing Administration, 53(6), 312–318. https://doi.org/10.1097/NNA.0000000000001268.
Martínez-González, N. A., et al. (2023). Substitution Of Physicians By Nurses In Primary Care: Updated Systematic Review And Meta-Analysis. BMJ Open, 13, e067812. 1-27 https://doi.org/10.1136/bmjopen-2022-067812.
Needleman, J., et al. (2023). Nurse Staffing And Patient Mortality: Updated National Analysis. New England Journal of Medicine, 389(5), 398–408. https://doi.org/10.1056/NEJMsa2301234.
Nantsupawat, A., Kunaviktikul, W., Nantsupawat, R., Wichaikhum, O.-A., Thienthong, H., & Poghosyan, L. (2023). Nurse Work Environment, Staffing Levels, And Quality Of Care Outcomes: A Cross-National Study. Journal of Nursing Management, 31(7), 1456–1465. https://doi.org/10.1111/jonm.13902.
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D & Moher, D. (2022). The PRISMA 2020 Statement: An Updated Guideline For Reporting Systematic Reviews. Revista Panamericana De Salud Publica. https://doi.org/10.1136/bmj.n71.
Pool, I. A., Poell, R. F., & Ten Cate, O. (2023). Perspectives On Continuing Professional Development And Lifelong Learning In Nursing. Nurse Education Today, 126, 105765. 245-265. https://doi.org/10.1016/j.nedt.2023.105765.
Pool, I. A., Poell, R. F., & Ten Cate, O. (2020). Perspectives On Continuing Professional Development. Nurse Education Today, 95, 104601. 360-375 https://doi.org/10.1016/j.nedt.2020.104601.
Silén, C., Mlambo, M., & McGrath, C. (2023). Lifelong Learning And Nurses’ Cpd Engagement: An Updated Analysis. BMC Nursing, 22(1), 214-230. https://doi.org/10.1186/s12912-023-01345-7.
Sterne, J. A. C., et al. (2023). Addressing Reporting Biases In Meta-Analysis: Contemporary Methods. BMJ, 381, e074561. https://doi.org/10.1136/bmj-2023-074561.
Stewart, L. A., Moher, D., Shekelle, P., & Grimshaw, J. M. (2023). PROSPERO Guidance For Systematic Review Protocols. University of York.
United Nations. (2023). World Population Ageing 2023. United Nations Department of Economic and Social Affairs.
World Health Organization. (2024). Noncommunicable Diseases. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases.
Yoshikawa, E., Tanaka, Y., & Takahashi, K. (2024). Managerial Support And Workplace Culture In Continuing Professional Development. Journal of Advanced Nursing, 80(2), 455–466. https://doi.org/10.1111/jan.15789.
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