Warwick Medical School, University of Warwick, Coventry University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Diabet Med. 2012 Oct;29(10):1237-52. doi: 10.1111/j.1464-5491.2012.03701.x.
To examine the evidence on culturally competent interventions tailored to the needs of people with diabetes from ethnic minority groups.
MEDLINE (NHS Evidence), CINAHL and reference lists of retrieved papers were searched from inception to September 2011; two National Health Service specialist libraries were also searched. Google, Cochrane and DARE databases were interrogated and experts consulted. Studies were included if they reported primary research on the impact of culturally competent interventions on outcome measures of any ethnic minority group with diabetes. Paper selection and appraisal were conducted independently by two reviewers. The heterogeneity of the studies required narrative analysis. A novel culturally competent assessment tool was used to systematically assess the cultural competency of each intervention.
Three hundred and twenty papers were retrieved and 11 included. Study designs varied with a diverse range of service providers. Of the interventions, 64% were found to be highly culturally competent (scoring 90-100%) and 36% moderately culturally competent (70-89%). Data were collected from 2616 participants on 22 patient-reported outcome measures. A consistent finding from 10 of the studies was that any structured intervention, tailored to ethnic minority groups by integrating elements of culture, language, religion and health literacy skills, produced a positive impact on a range of patient-important outcomes.
Benefits in using culturally competent interventions with ethnic minority groups with diabetes were identified. The majority of interventions described as culturally competent were confirmed as so, when assessed using the culturally competent assessment tool. Further good quality research is required to determine effectiveness and cost-effectiveness of culturally competent interventions to influence diabetes service commissioners.
考察针对少数民族糖尿病患者需求而量身定制的文化能力干预措施的证据。
从建库起至 2011 年 9 月，检索 MEDLINE（NHS 证据）、CINAHL 和检索文献的参考文献；还检索了两家国家卫生服务专业图书馆。查询了 Google、Cochrane 和 DARE 数据库，并咨询了专家。如果研究报告了文化能力干预措施对任何少数民族糖尿病患者的任何结局指标的影响的原始研究，则纳入研究。由两名评审员独立进行论文选择和评估。由于研究的异质性，需要进行叙述性分析。使用一种新颖的文化能力评估工具系统地评估每个干预措施的文化能力。
检索到 320 篇论文，其中 11 篇被纳入。研究设计各不相同，服务提供者也多种多样。在这些干预措施中，有 64%被认为具有高度文化能力（评分 90-100%），36%具有中等文化能力（评分 70-89%）。在 22 项患者报告结局测量中，从 2616 名参与者处收集了数据。10 项研究中有一个一致的发现，即任何针对少数民族群体的结构化干预措施，通过整合文化、语言、宗教和健康素养技能等元素，都能对一系列患者重要结局产生积极影响。
在针对少数民族糖尿病患者使用文化能力干预措施方面，已经确定了其益处。当使用文化能力评估工具评估时，大多数被描述为具有文化能力的干预措施被确认为如此。需要进一步开展高质量的研究，以确定文化能力干预措施在影响糖尿病服务决策者方面的有效性和成本效益。
