Catherine McAuley School of Nursing, Brookfield Health Science Complex, University College Cork, Cork, Ireland.
J Adv Nurs. 2010 Dec;66(12):2604-19. doi: 10.1111/j.1365-2648.2010.05423.x. Epub 2010 Aug 23.
This paper is a report of a review of the science of intervention development for type 1 diabetes in childhood and its implications for improving health outcomes in children, adolescents, and/or their families.
Previous reviewers have identified insufficient evidence to support the application of effective interventions for type 1 diabetes in clinical practice. The need for quality randomized controlled trials to address shortcomings in previous study designs has been highlighted as a priority for future intervention research. However, there is also a need to consider the scientific development of interventions, which to date has received little attention.
A search for published randomized controlled trials over 5 years (2004-2008) was conducted in electronic databases (Medline, CINAHL, Cochrane Library, Psychinfo, ERIC). Reference lists of papers identified from electronic searches were examined for additional papers.
A systematic review was conducted. Studies were included if (i) an intervention for managing any aspect of type 1 diabetes was implemented, (ii) children, adolescents and/or their families were sampled, (iii) a randomized controlled trial, (iv) published in English.
Fourteen randomized controlled trials were reviewed on education (n = 7), psychosocial (n = 5) and family therapy (n = 2) interventions. Compared to education interventions, family therapy and most psychosocial interventions were developed with greater scientific rigour, and demonstrated promising effects on more health outcomes measured.
Interventions developed within clearly-defined scientific criteria offer potential for improving health outcomes in children and adolescents with type 1 diabetes and their families. Future reviews on interventions for type 1 diabetes in childhood need to include criteria for assessing the science of intervention development.
本文是一篇综述报告，旨在评估儿童 1 型糖尿病干预措施的科学性，并探讨其对改善儿童、青少年及其家庭健康结局的意义。
既往综述发现，目前支持将有效的干预措施应用于临床实践的证据不足。为提高未来干预研究的质量，有必要开展高质量的随机对照试验，以弥补既往研究设计的不足。然而，还需要考虑干预措施的科学发展，这一点迄今为止尚未得到太多关注。
在电子数据库（Medline、CINAHL、Cochrane 图书馆、Psychinfo、ERIC）中检索了 5 年内（2004-2008 年）发表的随机对照试验。对电子检索中确定的论文的参考文献列表进行了进一步的文献检索。
对随机对照试验进行系统评价。纳入的研究需符合以下标准：（i）实施了管理 1 型糖尿病任何方面的干预措施，（ii）纳入了儿童、青少年及其家庭，（iii）为随机对照试验，（iv）以英文发表。
共综述了 14 项关于教育（n = 7）、心理社会（n = 5）和家庭治疗（n = 2）干预措施的随机对照试验。与教育干预相比，家庭治疗和大多数心理社会干预在制定时具有更高的科学严谨性，并在更多健康结局指标上显示出有前景的效果。
基于明确科学标准制定的干预措施有可能改善 1 型糖尿病儿童及其家庭的健康结局。未来关于儿童 1 型糖尿病干预措施的综述需要纳入评估干预措施科学性的标准。
