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采用老年友好型同伴主导的社区教育与指导模式改善骨质疏松症的诊断和治疗:一项随机对照试验

Improving the diagnosis and treatment of osteoporosis using a senior-friendly peer-led community education and mentoring model: a randomized controlled trial.

作者信息

Kloseck Marita, Fitzsimmons Deborah A, Speechley Mark, Savundranayagam Marie Y, Crilly Richard G

机构信息

Sam Katz Community Health and Aging Research Unit.

Division of Geriatric Medicine, Western University, London, ON, Canada.

出版信息

Clin Interv Aging. 2017 May 16;12:823-833. doi: 10.2147/CIA.S130573. eCollection 2017.

Abstract

BACKGROUND

This randomized controlled trial (RCT) evaluated a 6-month peer-led community education and mentorship program to improve the diagnosis and management of osteoporosis.

METHODS

Ten seniors (74-90 years of age) were trained to become peer educators and mentors and deliver the intervention. In the subsequent RCT, 105 seniors (mean age =80.5±6.9; 89% female) were randomly assigned to the peer-led education and mentorship program (n=53) or control group (n=52). Knowledge was assessed at baseline and 6 months. Success was defined as discussing osteoporosis risk with their family physician, obtaining a bone mineral density assessment, and returning to review their risk profile and receive advice and/or treatment.

RESULTS

Knowledge of osteoporosis did not change significantly. There was no difference in knowledge change between the two groups (mean difference =1.3, 95% confidence interval [CI] of difference -0.76 to 3.36). More participants in the intervention group achieved a successful outcome (odds ratio 0.16, 95% CI 0.06-0.42, <0.001).

CONCLUSION

Peer-led education and mentorship can promote positive health behavior in seniors. This model was effective for improving osteoporosis risk assessment, diagnosis, and treatment in a community setting.

摘要

背景

这项随机对照试验(RCT)评估了一项为期6个月的由同龄人主导的社区教育和指导计划,以改善骨质疏松症的诊断和管理。

方法

培训了10名老年人(74 - 90岁)成为同龄人教育者和指导者,并实施干预措施。在随后的随机对照试验中,105名老年人(平均年龄 = 80.5±6.9;89%为女性)被随机分配到由同龄人主导的教育和指导计划组(n = 53)或对照组(n = 52)。在基线和6个月时评估知识水平。成功的定义为与家庭医生讨论骨质疏松症风险、进行骨密度评估,并返回复查风险状况并接受建议和/或治疗。

结果

骨质疏松症知识没有显著变化。两组之间的知识变化没有差异(平均差异 = 1.3,差异的95%置信区间[CI]为 - 0.76至3.36)。干预组中更多参与者取得了成功结果(优势比0.16,95%CI为0.06 - 0.42,<0.001)。

结论

由同龄人主导的教育和指导可以促进老年人的积极健康行为。该模式在社区环境中对于改善骨质疏松症风险评估、诊断和治疗是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a025/5440001/c5c0a8995c5e/cia-12-823Fig1.jpg

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