Department of Nursing, Khoo Teck Puat Hospital, Yishun Health Campus, National Healthcare Group, Singapore City, Singapore.
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore.
J Clin Nurs. 2019 May;28(9-10):1433-1450. doi: 10.1111/jocn.14795. Epub 2019 Feb 12.
To perform a systematic review search and critically review the empirical evidence concerning the factors affecting glycaemic control in patients with type 1 or 2 diabetes mellitus.
Previous primary studies have investigated the factors associated with glycaemic control among patients with type 1 or 2 diabetes, but attempts to amalgamate these evidences have been methodologically limited. Hence, a robust review of the evidence is essential to explore factors that can be addressed to promote good glycaemic control in patients with diabetes.
Mixed-method systematic review using the Preferred Reporting Items for Systematic review and Meta-Analysis 2009 flow diagram, integrating evidence from qualitative and quantitative studies (see Supporting Information File S1).
A systematic review of the literature published between 2006-2017 was conducted in seven electronic databases (CINAHL, MEDLINE, Scopus, EMBASE, PsycINFO, PubMed and ScienceDirect) using the search terms "diabetes mellitus," "glycemic control," "self-concept," "knowledge," "self-efficacy," "empowerment," "race," "ethnicity," "duration," "medication," "obesity" and "comorbidity."
A total of 1,582 articles were initially retrieved, and 24 of these articles were included in this systematic literature review. The overall empirical evidence suggested that higher socio-economic status, greater dietary knowledge, and higher self-efficacy and empowerment improve glycaemic control among patients with diabetes mellitus.
This review presented the factors associated with glycaemic control that may pose significant socio-economic problems to most nations worldwide and impede development nationally, regionally and even globally. Greater emphasis needs to be placed on implementing lifestyle changes on a societal level to stem the tide of the epidemic.
There is a need to implement self-management initiatives, that incorporate dietary knowledge, to empower patients with diabetes in their own care. Future public health policy must be geared towards increasing the capability of dealing with the rising incidence of diabetes and implementing primary prevention.
进行系统检索并批判性地评价 1 型或 2 型糖尿病患者血糖控制影响因素的实证证据。
先前的初步研究已经调查了 1 型或 2 型糖尿病患者血糖控制相关因素，但综合这些证据的尝试在方法上受到限制。因此，对证据进行全面审查对于探索可以促进糖尿病患者良好血糖控制的因素至关重要。
使用 2009 年系统评价和荟萃分析首选报告项目的混合方法系统评价，整合定性和定量研究的证据（见支持信息文件 S1）。
在七个电子数据库（CINAHL、MEDLINE、Scopus、EMBASE、PsycINFO、PubMed 和 ScienceDirect）中，使用“糖尿病”、“血糖控制”、“自我概念”、“知识”、“自我效能”、“赋权”、“种族”、“民族”、“持续时间”、“药物”、“肥胖”和“合并症”等检索词，对 2006-2017 年间发表的文献进行系统综述。
最初检索到 1582 篇文章，其中 24 篇文章被纳入本系统文献综述。总体实证证据表明，较高的社会经济地位、更多的饮食知识以及更高的自我效能和赋权有助于改善糖尿病患者的血糖控制。
本综述提出了与血糖控制相关的因素，这些因素可能给世界上大多数国家带来重大的社会经济问题，并阻碍国家、地区甚至全球的发展。需要更加重视在社会层面上实施生活方式的改变，以遏制这一流行病的蔓延。
需要实施自我管理计划，将饮食知识纳入其中，增强糖尿病患者自我护理的能力。未来的公共卫生政策必须着眼于提高应对糖尿病发病率上升的能力，并实施初级预防。
