Ekong Gladys, Kavookjian Jan
Health Outcomes Research and Policy Department, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA.
Health Outcomes Research and Policy Department, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA.
Patient Educ Couns. 2016 Jun;99(6):944-52. doi: 10.1016/j.pec.2015.11.022. Epub 2015 Dec 4.
The management of type 2 diabetes (T2D) requires complex behavior changes and treatment regimens to achieve optimal outcomes. Interventions including motivational interviewing (MI) have been explored to help patients achieve behavior change and outcomes; this study aimed to explore evidence and gaps in the literature for MI interventions and outcomes in adults with T2D.
A modified Cochrane method structured the search strategy among databases including MEDLINE, CINAHL, PsycINFO, and others. Inclusion criteria included randomized controlled trials that assessed the effects of MI on behavior changeoutcomes and resultant clinical outcomes in adults with T2D.
Of the initial 159 studies identified, 14 were eligible for retention. Behavior targets in the retained studies included dietary changes, physical activity, smoking cessation, and alcohol reduction. MI had significant impact on some dietary behaviors and on weight loss. MI intervention structures were heterogeneous across studies; fidelity assessment was infrequent.
The effects of MI interventions on outcomes in T2D showed promising results for dietary behaviors. Clinical change outcomes from MI-based interventions were most favorable for weight management in T2D.
Behavior-specific MI interventions may positively influence study outcomes. Assessment of MI intervention fidelity will enhance treatment integrity and claims for validity.
2型糖尿病（T2D）的管理需要复杂的行为改变和治疗方案以实现最佳疗效。包括动机性访谈（MI）在内的干预措施已被探索用于帮助患者实现行为改变和取得疗效；本研究旨在探讨关于T2D成人患者MI干预措施及疗效的文献证据和差距。
采用改良的Cochrane方法在包括MEDLINE、CINAHL、PsycINFO等在内的数据库中构建检索策略。纳入标准包括评估MI对T2D成人患者行为改变结果及由此产生的临床疗效影响的随机对照试验。
在最初识别出的159项研究中，14项符合纳入标准。纳入研究中的行为目标包括饮食改变、体育活动、戒烟和减少饮酒。MI对某些饮食行为和体重减轻有显著影响。各研究间MI干预结构存在异质性；很少进行保真度评估。
MI干预措施对T2D疗效的影响在饮食行为方面显示出有前景的结果。基于MI的干预措施的临床改变结果对T2D体重管理最为有利。
针对特定行为的MI干预措施可能对研究结果产生积极影响。对MI干预保真度的评估将提高治疗的完整性及有效性主张。
