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糖尿病交流地图™与健康结局:一项系统文献综述

Diabetes Conversation Map™ and health outcomes: A systematic literature review.

作者信息

Srulovici Einav, Key Calanit, Rotem Mina, Golfenshtein Nadya, Balicer Ran D, Shadmi Efrat

机构信息

School of Nursing, University of Haifa, Haifa, Israel; Clalit Research Insitute, Clalit Health Services, Tel Aviv, Israel.

Community Nursing Division, Clalit Health Services, Tel Aviv, Israel.

出版信息

Int J Nurs Stud. 2017 May;70:99-109. doi: 10.1016/j.ijnurstu.2017.02.004. Epub 2017 Feb 10.

Abstract

OBJECTIVES

To identify, describe, and assess the evidence regarding the effects that the Diabetes Conversation Map™ program, an educational tool that engages patients with diabetes in group discussions about diabetes-related topics, has over a range of patient outcomes.

STUDY DESIGN

A systematic review.

DATA SOURCES

Five databases, including PubMed, CINAHL, Scopus, EMBASE, and Cochrane Collaboration, were utilized to identify studies that evaluated the Conversation Map™ program. Additionally, the reference lists of the identified studies were manually reviewed.

REVIEW METHODS

Studies that evaluated the Conversation Map™ program since 2005 were included. Non-English languages, non-journal papers, and studies that only included a description of the program were excluded. A quality assessment of relevant studies was performed. Outcomes were grouped into: objective (e.g., HbA1c levels), subjective (e.g., self-efficacy), and health behaviors (e.g., medication adherence).

RESULTS

Of the 85 studies originally identified, 24 studies were included in the final sample. The overall methodological quality of the studies was intermediate (score: 17 of 28). Almost all studies examined objective health measures, with most indicating non-significant differences between the Conversation Map™ intervention and the control groups. Conflicting results were found regarding the influence the program had on HbA1c. The majority of studies reported no significant change in blood pressure and mixed results were found regarding other health indicators. Twelve studies examined subjective measures and 11 assessed the effects on health behaviors, mostly reporting non-significant or positive findings.

CONCLUSIONS

Our review shows that although the Diabetes Conversation Map™ program holds the potential to improve patient behaviors and outcomes, current research on the program provides limited support as to their relationship with positive patient outcomes. Larger, more sophisticated studies are needed in order to determine the potential influence Conversation Map™ can have on long-term health outcomes.

摘要

目的

识别、描述并评估有关糖尿病交流地图(Diabetes Conversation Map™)项目效果的证据。该项目是一种教育工具,可让糖尿病患者参与有关糖尿病相关话题的小组讨论,并探讨其对一系列患者结局的影响。

研究设计

系统评价。

数据来源

使用了五个数据库,包括PubMed、CINAHL、Scopus、EMBASE和Cochrane协作网,以识别评估交流地图项目的研究。此外,还对已识别研究的参考文献列表进行了人工查阅。

综述方法

纳入2005年以来评估交流地图项目的研究。排除非英语语言、非期刊论文以及仅包含该项目描述的研究。对相关研究进行质量评估。结局分为:客观指标(如糖化血红蛋白水平)、主观指标(如自我效能感)和健康行为(如药物依从性)。

结果

在最初识别的85项研究中,最终样本纳入了24项研究。这些研究的总体方法学质量中等(得分:28分中的17分)。几乎所有研究都考察了客观健康指标,大多数研究表明交流地图干预组与对照组之间无显著差异。关于该项目对糖化血红蛋白的影响,研究结果相互矛盾。大多数研究报告血压无显著变化,其他健康指标的研究结果不一。12项研究考察了主观指标,11项评估了对健康行为的影响,大多报告无显著或阳性结果。

结论

我们的综述表明,尽管糖尿病交流地图项目有改善患者行为和结局的潜力,但目前关于该项目的研究对其与积极患者结局之间的关系支持有限。需要进行更大规模、更复杂的研究,以确定交流地图对长期健康结局的潜在影响。

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