School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
Global Institute for Interdisciplinary Studies (GIIS), Kathmandu, Nepal.
Syst Rev. 2020 Feb 29;9(1):45. doi: 10.1186/s13643-020-01302-z.
Self-care behaviors in people living with type 2 diabetes are important to achieving optimal glycemic control. Major depression in type 2 diabetes is associated with decreased adherence to self-care behaviors. The association between subthreshold depression and self-care behaviors, however, has not previously been systematically reviewed. The objective of this review is to determine the association between subthreshold depression and self-care behaviors.
A systematic search was performed in five electronic databases that included MEDLINE, EMBASE, PsycINFO, Emcare, and CINAHL. Any observational studies in adults with type 2 diabetes, investigating the association between subthreshold depression and any self-care behaviors, were included in the review. Qualitative studies, review articles, and gray literature were excluded. Two reviewers independently completed the title and abstract and full-text screening, appraised the study quality, and extracted the data. A third reviewer resolved any discrepancies between the reviewers if needed. Included articles were critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Meta-analyses were not conducted because criteria for conducting such analyses were not met.
A total of 6408 articles were identified through the database searching. After the abstract and full-text review, two articles met the inclusion criteria. One of the included study was cross-sectional while the other was a longitudinal study. Both studies showed inconsistent findings in the association between subthreshold depression and self-care behaviors. Important risks of bias were identified in the included studies.
The evidence from the two included studies on a possible association between subthreshold depression and self-care behaviors in adults with type 2 diabetes was not consistent and potentially biased. Our review established a gap in knowledge and suggests that further high-quality studies are needed to examine the association between subthreshold depression and self-care behaviors in people with type 2 diabetes.
PROSPERO CRD42018116373.
2 型糖尿病患者的自我护理行为对于实现血糖的最佳控制非常重要。2 型糖尿病伴发的重度抑郁症与自我护理行为的依从性降低有关。然而，亚临床抑郁症与自我护理行为之间的关系尚未被系统地综述过。本综述的目的是确定亚临床抑郁症与自我护理行为之间的关系。
在五个电子数据库（包括 MEDLINE、EMBASE、PsycINFO、Emcare 和 CINAHL）中进行了系统检索。纳入了任何针对 2 型糖尿病成人，调查亚临床抑郁症与任何自我护理行为之间关系的观察性研究。排除了定性研究、综述文章和灰色文献。两名审查员独立完成标题和摘要以及全文筛选、评估研究质量和提取数据。如果需要，由第三名审查员解决审查员之间的分歧。纳入的文章使用 Joanna Briggs 研究所（JBI）的批判性评估清单进行了批判性评估。由于不符合进行此类分析的标准，因此未进行荟萃分析。
通过数据库搜索共确定了 6408 篇文章。经过摘要和全文审查，有两篇文章符合纳入标准。其中一项研究为横断面研究，另一项为纵向研究。这两项研究都显示了亚临床抑郁症和自我护理行为之间的关联不一致的发现。纳入研究存在重要的偏倚风险。
两项纳入的研究在 2 型糖尿病成人中，亚临床抑郁症与自我护理行为之间可能存在关联的证据并不一致，且可能存在偏倚。我们的综述确定了知识上的差距，并表明需要进一步进行高质量的研究来检验 2 型糖尿病患者中亚临床抑郁症与自我护理行为之间的关系。
PROSPERO CRD42018116373。
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