电话咨询干预改善代谢综合征患者的饮食习惯和代谢参数：一项随机对照试验。
Telephone counseling intervention improves dietary habits and metabolic parameters of patients with the metabolic syndrome: a randomized controlled trial.
作者信息
Fappa Evaggelia, Yannakoulia Mary, Ioannidou Maria, Skoumas Yannis, Pitsavos Christos, Stefanadis Christodoulos
机构信息
Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
出版信息
Rev Diabet Stud. 2012 Spring;9(1):36-45. doi: 10.1900/RDS.2012.9.36. Epub 2012 May 10.
BACKGROUND
Patients with the metabolic syndrome (MetS) can suffer from poor metabolic parameters through lack of adherence to requisite lifestyle changes in dietary and physical activity. Usually, interventions in MetS patients are infrequent face-to-face consultations. The low frequency or absence of counseling interviews leads to a shortage of information and motivation to adhere to the recommended lifestyle changes. Telephone interventions could be an additional low-cost tool for effective interventions.
AIM
To evaluate the effectiveness of telephone intervention in improving lifestyle habits and metabolic parameters in MetS patients compared with similar face-to-face or a usual care interventions.
METHODS
Eighty-seven MetS patients recruited from the outpatient clinic of a major public hospital were randomly assigned to one of the three intervention groups: "usual care", "telephone" or "face-to-face". At the beginning of the study, all patients were provided with a hypocaloric Mediterranean-type diet. Afterwards, patients in the telephone group received 7 dietary counseling calls, patients in the face-to-face group participated in 7 one-to-one dietary counseling sessions, while patients in the usual care group received no other contact until the end of the study, 6 months later. All patients underwent full medical and nutritional evaluation at the beginning and at the end of the intervention.
RESULTS
At the end of the intervention, 42% of the participants no longer showed symptoms of MetS; the reduction rates differed significantly between the groups (p = 0.024), with those in the face-to-face and telephone group exhibiting similar rates (52% and 54%, respectively, vs. 21% in the usual care group). Between-group analysis revealed that the face-to-face group achieved the greatest improvement in metabolic parameters, while the telephone group had the greatest improvement in dietary adherence compared with the usual care group.
CONCLUSIONS
Telephone counseling is an effective way to implement behavioral counseling to improve lifestyle habits in MetS patients.
背景
代谢综合征（MetS）患者可能因未坚持必要的饮食和体育活动等生活方式改变而出现代谢参数不佳的情况。通常，对MetS患者的干预是不频繁的面对面咨询。咨询访谈的频率低或缺乏会导致缺乏坚持推荐生活方式改变所需的信息和动力。电话干预可能是一种额外的低成本有效干预工具。
目的
与类似的面对面干预或常规护理干预相比，评估电话干预对改善MetS患者生活习惯和代谢参数的有效性。
方法
从一家大型公立医院的门诊招募了87名MetS患者，随机分配到三个干预组之一：“常规护理”组、“电话”组或“面对面”组。在研究开始时，所有患者都接受了低热量的地中海式饮食。之后，电话组的患者接受了7次饮食咨询电话，面对面组的患者参加了7次一对一的饮食咨询会议，而常规护理组的患者在6个月后的研究结束前没有接受其他接触。所有患者在干预开始和结束时都接受了全面的医学和营养评估。
结果
在干预结束时，42%的参与者不再表现出MetS症状；各组之间的缓解率差异显著（p = 0.024），面对面组和电话组的缓解率相似（分别为52%和54%，而常规护理组为21%）。组间分析显示，与常规护理组相比，面对面组在代谢参数方面改善最大，而电话组在饮食依从性方面改善最大。
结论
电话咨询是对MetS患者实施行为咨询以改善生活习惯的有效方式。
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