Schinckus Louise, Van den Broucke Stephan, Housiaux Marie
Psychological Sciences Research Institute, Catholic University of Louvain, Louvain-la-Neuve, Belgium.
Psychological Sciences Research Institute, Catholic University of Louvain, Louvain-la-Neuve, Belgium.
Patient Educ Couns. 2014 Jul;96(1):13-21. doi: 10.1016/j.pec.2014.04.002. Epub 2014 Apr 21.
As diabetes requires extensive self-care, self-management education is widely recommended to enhance the effectiveness and reduce the costs of treatment. While a variety of diabetes self-management (DSM) programs are available, the conditions for their effective implementation are not well documented. This paper reviews the literature on implementation fidelity (IF), the degree to which programs are delivered as intended, as a factor influencing the effectiveness of diabetes education.
Medical, psychological and educational research databases were searched to identify published studies on diabetes education describing the implementation process. Studies detailing the intervention adherence/fidelity/integrity were included to assess the way key elements of IF were addressed.
From an initial 418 abstracts, 20 published papers were retained for an in-depth analysis focusing on the components of IF. Intervention content was mainly assessed through observation, whereas intervention dose was more often assessed through self-report measures. Only one study addressed the relationship between IF and intervention effectiveness.
Despite the importance of IF to achieve program outcomes, IF of DSM programs remains largely under-investigated.
The results of this review suggest that reports on DSM education should systematically describe how the program was implemented. The impact of IF on program outcomes needs further investigation.
由于糖尿病需要广泛的自我护理，因此广泛推荐自我管理教育以提高治疗效果并降低治疗成本。虽然有多种糖尿病自我管理（DSM）项目可供选择，但其有效实施的条件尚无充分记录。本文回顾了关于实施保真度（IF）的文献，即项目按预期实施的程度，作为影响糖尿病教育效果的一个因素。
检索医学、心理学和教育研究数据库，以识别已发表的描述糖尿病教育实施过程的研究。纳入详细描述干预依从性/保真度/完整性的研究，以评估IF关键要素的处理方式。
从最初的418篇摘要中，保留了20篇已发表的论文进行深入分析，重点关注IF的组成部分。干预内容主要通过观察进行评估，而干预剂量更多地通过自我报告测量进行评估。只有一项研究探讨了IF与干预效果之间的关系。
尽管IF对实现项目成果很重要，但DSM项目的IF在很大程度上仍未得到充分研究。
本综述结果表明，关于DSM教育的报告应系统地描述项目的实施方式。IF对项目成果的影响需要进一步研究。
