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疾病特异性教育计划对慢性阻塞性肺疾病患者健康结局影响的荟萃分析。

A meta-analysis on the impact of disease-specific education programs on health outcomes for patients with chronic obstructive pulmonary disease.

机构信息

School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China.

出版信息

Geriatr Nurs. 2012 Jul-Aug;33(4):280-96. doi: 10.1016/j.gerinurse.2012.03.001. Epub 2012 May 16.

Abstract

Disease-specific education programs have become an important factor in the treatment and care of chronic conditions, such as heart failure and diabetes mellitus. However, the effectiveness of these educational methods on chronic obstructive pulmonary disease (COPD) remains unclear. The objective of this meta-analysis was to evaluate whether disease-specific education programs were beneficial to health-related quality of life (HRQoL) variables and other long-term health outcomes in patients with COPD. Using electronic databases (PubMed, Cochrane Library, Science Direct, Chinese Biomedical Data System, China National Knowledge Infrastructure, and Wanfang Database) and individual searches (published and unpublished Chinese studies), we identified 12 randomized controlled trials (RCTs; English and/or Chinese) from 1991 to 2011. A meta-analysis on these studies revealed a positive relationship between disease-specific education programs and HRQoL scores (as measured by the St. George's Respiratory Questionnaire). Moreover, educational programs were associated with increased knowledge about COPD, improved disease management skills, inhaler adherence, and decreased COPD-related emergency department visits and hospital admissions, as well as long-term effects on improving COPD patients' health outcomes. Although significant effects were not detected across all HRQoL variables and health measures, our findings suggest that education programs have the potential to be a valuable intervention for COPD patients. Our results provide a foundation for future research in this area, which we recommend as including more rigorously designed, large, randomized studies.

摘要

疾病特定的教育计划已成为治疗和护理慢性疾病(如心力衰竭和糖尿病)的重要因素。然而,这些教育方法对慢性阻塞性肺疾病(COPD)的有效性尚不清楚。本荟萃分析的目的是评估疾病特定的教育计划是否有益于 COPD 患者的健康相关生活质量(HRQoL)变量和其他长期健康结果。使用电子数据库(PubMed、Cochrane Library、Science Direct、中国生物医学文献数据库、中国国家知识基础设施和万方数据库)和个体搜索(已发表和未发表的中文研究),我们从 1991 年至 2011 年确定了 12 项随机对照试验(RCT;英文和/或中文)。对这些研究的荟萃分析表明,疾病特定的教育计划与 HRQoL 评分(通过圣乔治呼吸问卷测量)之间存在正相关关系。此外,教育计划与 COPD 知识的增加、疾病管理技能的提高、吸入器的坚持使用、COPD 相关急诊就诊和住院的减少以及对改善 COPD 患者健康结果的长期影响有关。尽管在所有 HRQoL 变量和健康测量中都未检测到显著效果,但我们的研究结果表明,教育计划有可能成为 COPD 患者的一种有价值的干预措施。我们的研究结果为该领域的未来研究提供了基础,建议开展更具严谨性、大规模、随机的研究。

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