Perera Nilushka, Agboola Shade
Evaluation, Impact and Policy, Best Beginnings, Battaramulla, Sri Lanka.
Public Health, Nottingham City Council, Nottingham, UK.
BMJ Glob Health. 2019 Nov 6;4(Suppl 10):e001415. doi: 10.1136/bmjgh-2019-001415. eCollection 2019.
Preventative interventions are shown to be effective in reducing 40% of the mortality due to unhealthy behaviours and lifestyles. Health-promoting self-care has been recognised as a promising strategy in preventative health. However, self-care research is being done around the self-management of chronic illnesses and the promotion of self-care practices among healthy populations has been overlooked by many healthcare systems.
The study methodology was a systematic review with a narrative synthesis. The search was done through seven academic databases, reference tracking of selected articles and grey literature. The scoping, selection, screening and quality assessments of the articles were reviewed independently by two reviewers.
Sixteen studies met the inclusion criteria. Self-care behaviour, health-promotive lifestyle changes and medical care utilisation were some of the main outcomes evaluated in the studies. Positive effects were seen in increasing self-care and health-promotive behaviours in most interventions although limited or mixed impact was seen in health attitudes, beliefs and utilisation of medical services. Most studies were from high income settings with low-quality study designs. The complexity of the word 'self-care' and inconsistencies in the terminology used in health-promotive self-care were significant highlights of the study.
Health-promoting preventative self-care interventions show promise in increasing the well-being of healthy people. However, the methodological drawbacks limit the generalisability of the findings. As the demand for self-care interventions increases, the lack of a formal globally accepted definition and framework and complexity of behaviour change are key limitations to consider moving forward.
预防性干预措施已被证明能有效降低40%因不健康行为和生活方式导致的死亡率。促进健康的自我护理已被视为预防性健康领域一项有前景的策略。然而，目前的自我护理研究主要围绕慢性病的自我管理展开，许多医疗保健系统忽视了在健康人群中推广自我护理实践。
本研究采用系统综述和叙述性综合分析的方法。通过七个学术数据库、对所选文章的参考文献追踪以及灰色文献进行检索。两名评审员独立对文章的范围界定、选择、筛选和质量评估进行审查。
16项研究符合纳入标准。自我护理行为、促进健康的生活方式改变以及医疗服务利用是这些研究中评估的一些主要结果。在大多数干预措施中，自我护理和促进健康行为有所增加，尽管在健康态度、信念和医疗服务利用方面的影响有限或好坏参半。大多数研究来自高收入地区，研究设计质量较低。“自我护理”一词的复杂性以及促进健康的自我护理中术语使用的不一致性是该研究的显著亮点。
促进健康的预防性自我护理干预措施在提高健康人群福祉方面显示出前景。然而，方法上的缺陷限制了研究结果的普遍性。随着对自我护理干预需求的增加，缺乏正式的全球公认定义和框架以及行为改变的复杂性是未来需要考虑的关键限制因素。
