Center for Transitions and Health University of Pennsylvania, Philadelphia, PA, USA.
J Adv Nurs. 2012 Mar;68(3):496-510. doi: 10.1111/j.1365-2648.2011.05860.x. Epub 2011 Oct 20.
To evaluate the evidence on the effectiveness of tailored interventions on self-management behaviours in individuals with heart disease, hypertension or type 2 diabetes.
Tailored interventions are designed for individuals based on their unique characteristics, related to the outcome of interest, and derived from an individual assessment. Recognizing the differences between individuals and delivering interventions tailored to the individual could increase the likelihood of sustained self-management of long-term conditions. Review methods. A review of randomized controlled trials published between 2001 and 2010 was undertaken using the following databases: Pubmed, WOS, CINAHL, ERIC, ASP, PsychInfo and SSA. The search terms included tailored intervention(s), and self-management of chronic diseases included in the aim. Reference lists from relevant articles were also examined for additional references.
Ten studies were included in the review. Tailored interventions had no impact on self-management activities such as medication adherence, self-monitoring, exercise, smoking, or diet control. However, tailored interventions were modestly successful in improving specific self-management behaviours of dietary fat intake, levels of physical activity or screening. Studies included in the review generally suffered from compromised methodological issues of inadequately powered sample size, non-blinding of data collection or intervention delivery and inadequate reporting of the randomization process.
When cost and resource utilization is taken into consideration, tailored interventions may not be more effective than standard interventions in improving self-management behaviours in individuals with long-term conditions. Future research should explore the effect of robust and resource-optimized tailored interventions on self-management outcomes for long-term conditions with high-quality trials.
评估针对心脏病、高血压或 2 型糖尿病患者自我管理行为的定制干预措施的有效性证据。
定制干预措施是根据个体的独特特征设计的，这些特征与感兴趣的结果相关，并来自个体评估。认识到个体之间的差异并提供针对个体的干预措施可以增加长期疾病持续自我管理的可能性。
使用以下数据库对 2001 年至 2010 年间发表的随机对照试验进行了综述：Pubmed、WOS、CINAHL、ERIC、ASP、PsychInfo 和 SSA。搜索词包括定制干预措施和目标中包含的慢性疾病自我管理。还检查了相关文章的参考文献列表以获取其他参考文献。
共有 10 项研究纳入了综述。定制干预措施对药物依从性、自我监测、运动、吸烟或饮食控制等自我管理活动没有影响。然而，定制干预措施在改善饮食脂肪摄入、体力活动水平或筛查等特定自我管理行为方面取得了一定成效。纳入综述的研究普遍存在方法学问题，包括样本量不足、数据收集或干预措施实施不设盲以及随机化过程报告不充分。
考虑到成本和资源利用，定制干预措施在改善长期疾病患者的自我管理行为方面可能并不比标准干预措施更有效。未来的研究应该探索稳健且资源优化的定制干预措施对长期疾病自我管理结果的影响，开展高质量的试验。
