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系统评价同伴教育干预方案在 2 型糖尿病个体中的应用。

Systematic review of peer education intervention programmes among individuals with type 2 diabetes.

机构信息

School of Nursing, University of Nevada, Las Vegas, NV, USA.

出版信息

J Clin Nurs. 2017 Dec;26(23-24):4212-4222. doi: 10.1111/jocn.13991. Epub 2017 Sep 29.

Abstract

AIMS AND OBJECTIVES

To systematically review published randomised controlled trials of peer education interventions among adults with type 2 diabetes.

BACKGROUND

Systematic reviews have shown mixed results for peer support interventions to improve diabetes self-management. Given the effectiveness of diabetes education by healthcare professionals, peer education interventions may be a useful alternative approach. This review addressed that gap.

DESIGN

Systematic review.

METHOD

A systematic search of published randomised controlled trials between 2006-2016 was conducted using the keywords diabetes, type 2 diabetes, randomised controlled trials, self-management, peer education and peer support. The methodological quality of each study was assessed using the Jadad scale.

RESULTS

Seven studies were included in the final review, and the Jadad scores ranged from 8-10 of a possible 13 points. There was no consistent design, setting, or outcome measurement among the studies. There were two types of peer education interventions compared to traditional diabetes education: face-to-face or a combination of face-to-face and telephone/texting. The most common clinical outcome measure was HbA1c. Two of six studies showed statistically significant improvement in HbA1c between intervention and control groups. An increase in diabetes knowledge was also statistically significant in two of five studies.

CONCLUSION

Peer education could be successful in improving clinical outcomes. No evidence was found indicating that healthcare provider education was superior in regard to clinical knowledge or behavioural or psychological outcome measures than peer education. HbA1c was statistically significantly lower in some peer education groups compared to control groups.

RELEVANCE TO CLINICAL PRACTICE

There is evidence that peer education can be useful in achieving positive clinical outcomes such as decreasing HbA1c levels and increasing diabetes knowledge. A certified diabetes educator or a trained healthcare professional should not be overlooked though when using peer educators.

摘要

目的和目标

系统回顾已发表的 2 型糖尿病成人同伴教育干预的随机对照试验。

背景

系统评价显示,同伴支持干预措施在改善糖尿病自我管理方面的效果不一。鉴于医疗保健专业人员进行的糖尿病教育的有效性,同伴教育干预措施可能是一种有用的替代方法。本综述旨在解决这一差距。

设计

系统评价。

方法

使用关键词糖尿病、2 型糖尿病、随机对照试验、自我管理、同伴教育和同伴支持,对 2006 年至 2016 年期间发表的随机对照试验进行了系统搜索。使用 Jadad 量表评估每项研究的方法学质量。

结果

最终综述纳入了 7 项研究,Jadad 评分范围为 13 分中的 8-10 分。研究之间没有一致的设计、环境或结果测量。有两种类型的同伴教育干预措施与传统的糖尿病教育相比较:面对面或面对面与电话/短信相结合。最常见的临床结局测量是 HbA1c。六项研究中有两项显示干预组与对照组之间 HbA1c 有统计学显著改善。五项研究中有两项显示糖尿病知识增加也具有统计学显著意义。

结论

同伴教育在改善临床结局方面可能是成功的。没有证据表明医疗保健提供者教育在临床知识或行为或心理结局测量方面优于同伴教育。与对照组相比,一些同伴教育组的 HbA1c 统计学显著降低。

临床相关性

有证据表明,同伴教育在实现积极的临床结局方面是有用的,例如降低 HbA1c 水平和增加糖尿病知识。在使用同伴教育者时,不应忽视经过认证的糖尿病教育者或经过培训的医疗保健专业人员。

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