系统评价促进痴呆患者参与身体活动的行为改变技术。

Systematic review of behaviour change techniques to promote participation in physical activity among people with dementia.

机构信息

Department of Psychology and Ageing & Dementia Research Centre, Faculty of Science and Technology, Bournemouth University, Poole, Dorset, UK.

Department of Psychology, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK.

出版信息

Br J Health Psychol. 2018 Feb;23(1):148-170. doi: 10.1111/bjhp.12279. Epub 2017 Oct 4.

Abstract

PURPOSE

The objective of this study was to systematically review the evidence for the potential promise of behaviour change techniques (BCTs) to increase physical activity among people with dementia (PWD).

METHODS

PsychINFO, MEDLINE, CINAHL, and the Cochrane Central Register of Controlled Trials databases were searched 01/01/2000-01/12/2016. Randomized controlled/quasi-randomized trials were included if they recruited people diagnosed/suspected to have dementia, used at least one BCT in the intervention arm, and had at least one follow-up measure of physical activity/adherence. Studies were appraised using the Cochrane Collaboration Risk of Bias Tool, and BCTs were coded using Michie et al., 2013, Annals of Behavioral Medicine, 46, 81. taxonomy. Intervention findings were narratively synthesized as either 'very promising', 'quite promising', or 'non-promising', and BCTs were judged as having potential promise if they featured in at least twice as many very/quite promising than non-promising interventions (as per Gardner et al., 2016, Health Psychology Review, 10, 89).

RESULTS

Nineteen articles from nine trials reported physical activity findings on behavioural outcomes (two very promising, one quite promising, and two non-promising) or intervention adherence (one quite promising and four non-promising). Thirteen BCTs were used across the interventions. While no BCT had potential promise to increase intervention adherence, three BCTs had potential promise for improving physical activity behaviour outcomes: goal setting (behaviour), social support (unspecified), and using a credible source.

CONCLUSIONS

Three BCTs have potential promise for use in future interventions to increase physical activity among PWD. Statement of contribution What is already known on this subject? While physical activity is a key lifestyle factor to enhance and maintain health and wellbeing amongst the general population, adults rarely participate in sufficient levels to obtain these benefits. Systematic reviews suggest that specific behaviour change techniques can increase physical activity, although one review suggested that self-regulatory techniques may be counterproductive when promoting physical activity among older people. Until now, no systematic review has been conducted to assess which behaviour change techniques may be associated with greater participation in physical activity among people with dementia. What does this study add? Interventions showed mixed promise for increasing physical activity and little effect on participant adherence. Goal setting (behaviour), social support (unspecified), and using a credible source are promising approaches. No technique showed promise for increasing adherence to physical activity interventions among people with dementia.

摘要

目的

本研究旨在系统地回顾行为改变技术(BCTs)在增加痴呆症患者(PWD)身体活动方面的潜在作用。

方法

从 01/01/2000 年至 01/12/2016 年,检索了 PsychINFO、MEDLINE、CINAHL 和 Cochrane 对照试验中心注册库。如果研究招募了被诊断/疑似患有痴呆症的人群,在干预组中使用了至少一种 BCT,并且至少有一次随访身体活动/依从性的测量,则将其纳入随机对照/准随机试验。使用 Cochrane 协作风险偏倚工具评估研究,并使用 Michie 等人,2013 年,《行为医学年鉴》,46,81. 分类法对 BCT 进行编码。将干预结果描述为“非常有前景”、“相当有前景”或“没有前景”,如果在至少两倍的非常/相当有前景的干预措施中出现某种 BCT(如 Gardner 等人,2016 年,《健康心理学评论》,10,89),则认为该 BCT 具有潜在前景。

结果

来自九个试验的 19 篇文章报告了行为结果(两项非常有前景,一项相当有前景,两项没有前景)或干预依从性(一项相当有前景,四项没有前景)的身体活动发现。干预措施中使用了 13 种 BCT。虽然没有 BCT 有增加干预依从性的潜力,但有三种 BCT 对改善身体活动行为结果有潜在前景:目标设定(行为)、社会支持(不明确)和使用可信来源。

结论

在未来增加 PWD 身体活动的干预措施中,三种 BCT 具有潜在的应用前景。

关于这个主题,目前已知的是什么?虽然身体活动是增强和维持一般人群健康和幸福感的关键生活方式因素,但成年人很少参加足够的活动来获得这些益处。系统评价表明,特定的行为改变技术可以增加身体活动,尽管有一项评价表明,自我监管技术在促进老年人身体活动时可能适得其反。到目前为止,还没有系统的综述来评估哪些行为改变技术可能与痴呆症患者更高的身体活动参与度相关。

这项研究增加了什么?干预措施在增加身体活动方面显示出混合的前景,对参与者的依从性影响很小。目标设定(行为)、社会支持(不明确)和使用可信来源是有前途的方法。没有技术显示出在增加痴呆症患者身体活动干预措施的依从性方面有前景。

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