Cochran Jane, Conn Vicki S
The Missouri University Sinclair School of Nursing, Columbia, Missouri
Diabetes Educ. 2008 Sep-Oct;34(5):815-23. doi: 10.1177/0145721708323640.
The purpose of this meta-analysis was to meet the need to quantify the influence of diabetes self-management training on quality of life (QOL) of adult diabetes patients.
Extensive literature searching located published and unpublished diabetes self-management intervention studies that measured QOL outcomes among at least 5 subjects with type 1 or 2 diabetes. Data were extracted from primary study reports which included interventions designed to improve diabetes self-management and adequate data to calculate effect sizes. Random-effects meta-analytic procedures were used to estimate overall effects between treatment and control groups at outcome assessment and between baseline and outcome data for both treatment subjects and control subjects.
Exhaustive searching yielded 20 comparisons across 1892 subjects. The comparisons between treatment and control group outcomes following interventions yielded an effect size of 0.281. The comparisons between treatment group at baseline and outcome measurement yielded an effect size of 0.312 to 0.313. Each of these effect sizes were statistically significant, meaning that the hypothesis that interventions to improve diabetes self-management results in increased QOL was supported. Control subjects did not experience improved QOL while participating in studies.
These findings document that people with diabetes experience improved QOL from participation in diabetes self-management training programs. Future diabetes self-management intervention studies should include quality of life outcomes so that this important outcome can be further studied. After more primary studies are available, future meta-analyses can explore important moderator analyses.
本荟萃分析的目的是满足量化糖尿病自我管理培训对成年糖尿病患者生活质量(QOL)影响的需求。
通过广泛的文献检索,找到了已发表和未发表的糖尿病自我管理干预研究,这些研究测量了至少5名1型或2型糖尿病患者的生活质量结果。数据从主要研究报告中提取,其中包括旨在改善糖尿病自我管理的干预措施以及计算效应量的足够数据。采用随机效应荟萃分析程序来估计治疗组和对照组在结局评估时以及治疗组和对照组的基线与结局数据之间的总体效应。
详尽的检索得到了涉及1892名受试者的20项比较。干预后治疗组和对照组结局之间的比较得出效应量为0.281。治疗组基线与结局测量之间的比较得出效应量为0.312至0.313。这些效应量均具有统计学意义,这意味着改善糖尿病自我管理的干预措施会导致生活质量提高这一假设得到了支持。对照组在参与研究期间生活质量并未改善。
这些研究结果表明,糖尿病患者通过参与糖尿病自我管理培训项目,生活质量得到了改善。未来的糖尿病自我管理干预研究应纳入生活质量结局,以便能进一步研究这一重要结局。在有更多的原始研究可用之后,未来的荟萃分析可以探索重要的调节因素分析。