摘要
目的评价不同方式的自我管理教育对糖尿病患者糖化血红蛋白的影响。方法检索中国学术期刊网全文数据库、维普数据库、万方数据库和中国生物文献数据库(以糖尿病/自我管理/健康教育/行为/心理为关键词)和英文数据库Embase、PubMed、Cochrane(以intervention/knowledge/behavior/psychological/diabetes/DSME为关键词),检索时限自建库至2018年6月,同时手工检索相关领域杂志,全面搜集相关临床随机对照实验,进行文献质量评价后,采用RevMan 5.0软件进行数据分析。结果最终纳入文献16篇(以糖化血红蛋白为结局指标评价自我管理教育对糖尿病患者的影响),其中9篇行为干预亚组,4篇基本知识认知干预亚组和3篇心理干预亚组;3篇A级文献,13篇B级文献。Meta分析结果显示,行为干预亚组患者糖化血红蛋白水平WMD=-0.78,95%CI(-1.14,-0.41)(P<0.05);知识干预亚组WMD=-0.55,95%CI(-1.06,-0.04)(P<0.05),心理干预亚组WMD=-0.55,95%CI(-1.24,0.15)(P>0.05)。结论行为干预、基本知识认知干预对糖尿病患者的糖化血红蛋白均有正向作用,心理干预尚不能定论是否会影响患者的糖化血红蛋白水平。对糖尿病患者的自我管理教育应当从行为、认知、心理等多方面进行综合性的干预才能达到良好的效果。
Objective To evaluate the effects of different forms of self-management education on glycosylated hemoglobin (HbA1c) in diabetic patients. Methods The related clinical randomized controlled trials (RCTs) were retrieved in China National Knowledge Infrastructure (CNKI), VIP, WanFang data and Chinese Biomedical Database (CBM)(key words: diabetes/ self-management/ health education/ behavior/ psychology) and in Embase, PubMed, Cochrane (key words: of intervention/ knowledge/ behavior/ psychological/ diabetes/ DSME) from building the database to June 2018 as well as in related journals by hand. Then, we evaluated the quality of literature and carried out data analysis with the RevMan5.0. Results Finally, a total of 16 literatures (evaluating the effects of self-management education in diabetic patients with the outcome indexes of HbA1c) were included with 9 of them in the subgroup of behavior intervention, 4 in the subgroup of elementary knowledge cognitive intervention and 3 in the subgroup of mental intervention. Besides, 3 literatures with the level A and 13 with the level B. Meta-analysis showed that the HbA1c of the subgroup of behavior intervention was with WMD=-0.78, 95%CI (-1.14,-0.41)(P<0.05), HbA1c of the subgroup of elementary knowledge cognitive intervention was with WMD=-0.55, 95%CI (-1.06,-0.04)(P<0.05) and HbA1c of the subgroup of mental intervention was with WMD=-0.55, 95%CI (-1.24, 0.15)(P>0.05). Conclusions Behavior intervention and elementary knowledge cognitive intervention all have positive effects on HbA1c of diabetic patients. However, whether mental intervention has effects on patients' HbA1c has not gotten a final conclusion. We should implement comprehensive self-management education for diabetic patients from many aspects including behavior, cognition and psychology to achieve an ideal effect.
作者
金海君
郭兵妹
刘聪聪
祝筠
Jin Haijun;Guo Bingmei;Liu Congcong;Zhu Yun(Internal Medicine Outpatient, Shandong Provincial Hospital, Affiliated to Shandong University, Ji'nan 250021, China;Surgical Intensice Care Unit, Shandong Provincial Hospital, Affiliated to Shandong University, Ji'nan 250021, China;Office of Party Committee, Shandong Provincial Hospital, Affiliated to Shandong University, Ji'nan 250021, China;Department of Gastroenterology, Qilu Hospital, Ji'nan 250012, China)
出处
《中华现代护理杂志》
2019年第9期1139-1144,共6页
Chinese Journal of Modern Nursing
关键词
糖尿病
自我管理教育
糖化血红蛋白
META分析
Diabetes mellitus
Self-management education
Glycated hemoglobin A
Meta-analysis
