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疾病特异性自我管理教育对慢性阻塞性肺疾病患者健康结局的影响:更新的系统评价和荟萃分析。

Effectiveness of disease-specific self-management education on health outcomes in patients with chronic obstructive pulmonary disease: An updated systematic review and meta-analysis.

机构信息

Department of Nursing, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, Guangdong, China.

School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.

出版信息

Patient Educ Couns. 2017 Aug;100(8):1432-1446. doi: 10.1016/j.pec.2017.02.026. Epub 2017 Mar 1.

Abstract

OBJECTIVES

To update a previously published systematic review on the effectiveness of self-management education (SME) for patients with chronic obstructive pulmonary disease (COPD).

METHODS

Electronic databases were accessed (from inception to July 2016) to find relevant randomized controlled trials. Studies that compared SME with routine methods of care in COPD patients were retrieved. Both data synthesis and descriptive analysis were used for outcome assessment (e.g. quality of life and healthcare utilization).

RESULTS

Twenty-four studies were included. Data synthesis showed better quality of life among COPD patients receiving SME. Significant reductions in COPD-related hospital admissions and emergency department visits were identified in the SME group. SME may positively affect the reduction of COPD patients' emotional distress. No significant reduction in smoking rate and mortality rate was observed between groups. No clear evidence supports the improvement of pulmonary functions, dyspnea, and nutritional status in COPD patients with the use of SME.

CONCLUSION

SME can be a useful strategy to improve quality of life and disease-specific knowledge in patients with COPD. It also reduces respiratory-related hospital admissions and emergency department visits in COPD patients.

PRACTICE IMPLICATIONS

Inclusion of SME as one of the key components for the comprehensive management of COPD is encouraged.

摘要

目的

更新先前发表的关于慢性阻塞性肺疾病(COPD)患者自我管理教育(SME)有效性的系统评价。

方法

检索电子数据库(从创建到 2016 年 7 月)以查找相关的随机对照试验。检索了比较 SME 与 COPD 患者常规护理方法的研究。使用数据综合和描述性分析进行结果评估(例如生活质量和医疗保健利用)。

结果

纳入了 24 项研究。数据综合表明,接受 SME 的 COPD 患者生活质量更好。SME 组中 COPD 相关住院和急诊就诊次数明显减少。SME 可能对减轻 COPD 患者的情绪困扰产生积极影响。两组之间的吸烟率和死亡率均无明显下降。没有明确的证据表明 SME 可改善 COPD 患者的肺功能、呼吸困难和营养状况。

结论

SME 可以作为改善 COPD 患者生活质量和疾病特定知识的有用策略。它还可以减少 COPD 患者的呼吸道相关住院和急诊就诊次数。

实践意义

鼓励将 SME 纳入 COPD 综合管理的关键组成部分之一。

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