Department of Psychological Medicine, University of Auckland, Auckland, New Zealand.
Department of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Diabet Med. 2021 Mar;38(3):e14495. doi: 10.1111/dme.14495. Epub 2020 Dec 30.
This systematic review sought to synthesize the evidence regarding the effectiveness of illness perception interventions compared with control conditions at changing illness perceptions and improving glycaemic control in individuals with type 2 diabetes.
Seven electronic databases were searched between October 2018 and May 2020. Randomized controlled trials that tested interventions informed by the Common-Sense Model in adults with type 2 diabetes, and measured illness perceptions and glycaemic control at pre- and post-intervention were included. The Cochrane risk of bias tool was used to assess risk of bias.
A total of 4095 articles were identified, of which nine randomized control trials (2561 participants) across 12 publications were included in this review. Findings showed that all the illness perception domains were modified in at least one trial, with the exception of cyclical timeline perceptions. Coherence, personal control, treatment control and chronic timeline perceptions were the most frequently modified perceptions. Glycaemic control demonstrated an improvement in the intervention group compared to the control group at 3 and 6 months post-intervention in two trials. Risk of bias assessment showed high risk of bias especially for the blinding of participants and the personnel domain.
There is limited evidence that interventions informed by the Common-Sense Model can improve glycaemic control in individuals with type 2 diabetes through changing inaccurate illness perceptions. Recommendations for future research are to tailor intervention content based on baseline perceptions, measure the emotional and causal domains, and involve family members in the intervention. (PROSPERO registration: CRD42019114532).
本系统评价旨在综合关于疾病感知干预与对照条件相比在改变 2 型糖尿病患者的疾病感知和改善血糖控制方面的有效性的证据。
2018 年 10 月至 2020 年 5 月期间,检索了 7 个电子数据库。纳入了以 2 型糖尿病成人中常见感知模型为指导的干预措施进行测试,且在干预前后测量疾病感知和血糖控制的随机对照试验。使用 Cochrane 偏倚风险工具评估偏倚风险。
共确定了 4095 篇文章,其中有 12 篇出版物的 9 项随机对照试验(2561 名参与者)纳入了本综述。结果表明,除周期性时间观念外,所有疾病感知领域在至少一项试验中都有所改变。一致性、个人控制、治疗控制和慢性时间观念是最常改变的观念。在两项试验中,干预组在干预后 3 个月和 6 个月的血糖控制均优于对照组。偏倚风险评估显示,尤其是对参与者和人员领域的盲法存在高偏倚风险。
有有限的证据表明,以常见感知模型为指导的干预措施可以通过改变不准确的疾病感知来改善 2 型糖尿病患者的血糖控制。对未来研究的建议是根据基线感知定制干预内容,测量情感和因果领域,并让家庭成员参与干预。(PROSPERO 注册:CRD42019114532)。