C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada.
C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Patient Educ Couns. 2017 Oct;100(10):1787-1795. doi: 10.1016/j.pec.2017.04.011. Epub 2017 Apr 17.
To identify the characteristics of self-management programs for persons with Parkinson's disease and the evidence for their effectiveness.
An integrative literature review was conducted. Studies describing the provision or outcomes of self-management interventions for persons with Parkinson's disease and published in English were included. Two reviewers independently screened and evaluated articles. Interventions were described and compared, and evidence was presented using The Traffic Lighting system.
Eighteen interventions were identified, representing a variety of group- and individual-based interventions that differed in structure, components, and outcomes. Notably, 89% were designed specifically for persons with Parkinson's disease and 39% combined self-management support with other therapies. Evidence to support specific self-management programs for persons with Parkinson's disease was limited. However, a moderate quality systematic review and a good quality RCT supported self-management for improving specific domains of quality of life.
A variety of interventions have been designed to support self-management by persons with Parkinson's disease. More research is needed to identify key active ingredients and determine which programs are most effective.
Self-management programs embedded within rehabilitation are promising. Clinicians should ensure programs include goal setting and problem solving and consider the inclusion of caregivers and peer support.
确定帕金森病患者自我管理计划的特点及其有效性的证据。
进行了综合文献回顾。纳入了描述为帕金森病患者提供或结果的自我管理干预措施的研究，并以英文发表。两名审查员独立筛选和评估文章。使用交通信号灯系统描述和比较干预措施，并提出证据。
确定了 18 项干预措施，代表了各种基于小组和个人的干预措施，这些干预措施在结构、组成和结果上存在差异。值得注意的是，89%的干预措施是专门为帕金森病患者设计的，39%的干预措施将自我管理支持与其他治疗方法相结合。支持帕金森病患者特定自我管理计划的证据有限。然而，一项中等质量的系统评价和一项高质量的 RCT 支持自我管理可改善生活质量的特定领域。
已经设计了各种干预措施来支持帕金森病患者的自我管理。需要进一步研究以确定关键的有效成分，并确定哪些方案最有效。
嵌入康复中的自我管理计划很有前景。临床医生应确保计划包括目标设定和解决问题，并考虑纳入照顾者和同伴支持。
