Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore.
Int J Evid Based Healthc. 2012 Sep;10(3):169-80. doi: 10.1111/j.1744-1609.2012.00276.x.
To synthesise the evidence on how community-dwelling adults with type 1 and type 2 diabetes mellitus experience hypoglycaemia and the strategies they use to control it.
Using a three-step search strategy, all published and unpublished qualitative studies in English from January 2000 to August 2010 were retrieved. Participants diagnosed with type 1 or type 2 diabetes mellitus, experienced in self-managing their hypoglycaemia, and who lived independently in the community and attended primary care or outpatient clinics were included. An initial limited search was conducted in MEDLINE and CINAHL to identify keywords and index terms, which were then used in a second search across the CINAHL, PUBMED, SCOPUS, PsycINFO, PsycARTICLES, Web of Science, JSTOR, EMBASE and MEDNAR databases. Additionally, the reference lists of all retrieved papers were hand-searched for additional studies. Retrieved studies were assessed for methodological validity using the standardised Joanna Briggs Institute-Qualitative Assessment and Review Instrument (JBI-QARI). Data, in terms of research findings, were extracted from included studies using the standardised JBI-QARI data extraction tool. Five studies (six papers) were included in the review.
The 20 findings from the six papers were grouped into three categories, which were then synthesised into one overall finding - that is 'People with diabetes mellitus can self-manage their diabetes and thus prevent hypoglycaemic episodes more effectively when health professionals provide psychological, physiological and spiritual support, and an individually targeted education programme'.
Within the constraints of this review, it appears that the patient-identified priority is to maintain normality in blood glucose self-management. There is also evidence that some people lack the knowledge to identify and self-manage hypoglycaemia.
To enable community-dwelling adults with diabetes mellitus to self-manage hypoglycaemia, healthcare professionals should provide individualised information and emotional support and regularly discuss and assess the person's level of knowledge, awareness of hypoglycaemia and their ability to self-manage.
综合社区居住的 1 型和 2 型糖尿病患者经历低血糖的证据以及他们控制低血糖的策略。
使用三步搜索策略，检索了 2000 年 1 月至 2010 年 8 月期间所有以英文发表和未发表的定性研究。纳入的参与者被诊断患有 1 型或 2 型糖尿病，在自我管理低血糖方面有经验，独立居住在社区中，接受初级保健或门诊治疗。在 MEDLINE 和 CINAHL 中进行了初步的有限搜索，以确定关键词和索引词，然后在 CINAHL、PUBMED、SCOPUS、PsycINFO、PsycARTICLES、Web of Science、JSTOR、EMBASE 和 MEDNAR 数据库中进行了第二次搜索。此外，还对所有检索到的论文的参考文献进行了手工搜索，以获取其他研究。使用标准化的 Joanna Briggs 研究所定性评估和审查工具（JBI-QARI）评估纳入研究的方法学有效性。使用标准化的 JBI-QARI 数据提取工具从纳入的研究中提取数据，即研究结果。共有 5 项研究（6 篇论文）纳入综述。
从 6 篇论文中提取出的 20 项发现分为 3 类，然后综合为一个总体发现，即“当卫生专业人员提供心理、生理和精神支持以及个性化的教育计划时，糖尿病患者可以自我管理他们的糖尿病，从而更有效地预防低血糖发作”。
在本综述的限制范围内，似乎患者确定的首要任务是维持血糖自我管理的正常化。也有证据表明，有些人缺乏识别和自我管理低血糖的知识。
为了使社区居住的糖尿病患者能够自我管理低血糖，医护人员应提供个性化信息和情感支持，并定期讨论和评估患者的知识水平、对低血糖的认识以及自我管理能力。
