Sarkisian Catherine A, Brown Arleen F, Norris Keith C, Wintz Ruth L, Mangione Carol M
The Division of Geriatrics, Department of Medicine, UCLA School of Medicine, Los Angeles, California (Drs Sarkisian and Mangione)
The Division of General Internal Medicine and Health Services Research, Department of Medicine, UCLA School of Medicine, Los Angeles, California (Drs Brown and Mangione)
Diabetes Educ. 2003 May-Jun;29(3):467-79. doi: 10.1177/014572170302900311.
This study systematically identified and examined published self-care interventions designed to improve glycemic control or quality of life (QoL) among older, African American, or Latino adults.
Six electronic databases were searched. Eligible publications were those that described an intervention to change knowledge, beliefs, or behavior among adults with diabetes who were either older than 55 years, African American, or Latino, and that measured the outcomes of glycemic control or QoL.
Twelve studies met the inclusion criteria, of which 8 were randomized controlled trials (RCTs). Of the 8 RCTs, improved glycemic control was reported in the intervention arm of 5 RCTs compared with the control arm. Of the 4 RCTs that examined QoL, improved QoL was reported in the intervention arm of 1 study. Characteristics of successful interventions included poor glycemic control at baseline (A1C > 11%), cultural or age-tailoring the intervention, use of group counseling or support, and involvement of spouses and adult children.
Large-scale clinical trials designed according to cultural and age criteria specific for older Latinos and African Americans with diabetes are needed to determine how best to address this growing public health problem.
本研究系统地识别并审查了已发表的自我护理干预措施，这些措施旨在改善老年非裔美国人或拉丁裔成年人的血糖控制或生活质量（QoL）。
检索了六个电子数据库。符合条件的出版物是那些描述了针对年龄大于55岁、非裔美国人或拉丁裔的糖尿病成年人改变知识、信念或行为的干预措施，并测量了血糖控制或生活质量结果的研究。
12项研究符合纳入标准，其中8项为随机对照试验（RCT）。在8项RCT中，与对照组相比，5项RCT的干预组报告血糖控制得到改善。在4项研究生活质量的RCT中，1项研究的干预组报告生活质量得到改善。成功干预措施的特点包括基线血糖控制不佳（糖化血红蛋白>11%）、根据文化或年龄调整干预措施、使用团体咨询或支持以及配偶和成年子女的参与。
需要根据针对患有糖尿病的老年拉丁裔和非裔美国人的文化和年龄标准设计大规模临床试验，以确定如何最好地解决这一日益严重的公共卫生问题。
