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个性化老年护理计划中的行为改变技术:系统评价。

Behaviour change techniques in personalised care planning for older people: a systematic review.

机构信息

Leeds Institute of Clinical Trials Research, Clinical Trials Research Unit, University of Leeds, Leeds.

Academic Unit for Ageing and Stroke Research, University of Leeds, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford.

出版信息

Br J Gen Pract. 2021 Jan 28;71(703):e121-e127. doi: 10.3399/bjgp20X714017. Print 2021.

Abstract

BACKGROUND

Personalised care planning (PCP) interventions have the potential to provide better outcomes for older people and are a key focus in primary care practice. Behaviour change techniques (BCTs) can maximise effectiveness of such interventions, but it is uncertain which BCTs are most appropriate in PCP for older adults.

AIM

To identify BCTs used in successful PCP interventions for older people aged ≥65 years.

DESIGN AND SETTING

Systematic review.

METHOD

The authors searched 12 databases from date of inception to 30 September 2017. They identified randomised controlled trials (RCTs) of interventions involving participants aged ≥65 years, and contextually related to PCP. Five areas of risk of bias were assessed. The Michie BCT taxonomy was used for coding.

RESULTS

Twenty-three RCTs involving 6489 participants (average age 74 years) described PCP interventions targeting the general older adult population and older people with specific long-term conditions (for example, heart disease, diabetes, stroke). Just over half of the studies were deemed to be at a low risk of bias. Eleven 'promising' BCTs were identified in five trials reporting significant improvements in quality of life (QoL). Six BCTs were reported in all five of these trials: 'goal setting', 'action planning', 'problem solving', 'social support', 'instructions on how to perform a behaviour', and 'information on health consequences'. Modes of delivery varied.

CONCLUSION

Future PCP interventions to improve QoL for people aged ≥65 years may benefit from focusing on six specific BCTs. Better reporting of BCTs would enhance future design and implementation of such interventions.

摘要

背景

个性化护理计划(PCP)干预措施有可能改善老年人的预后,是初级保健实践的重点。行为改变技术(BCT)可以最大限度地提高此类干预措施的效果,但尚不确定哪些 BCT 最适合老年人的 PCP。

目的

确定针对年龄≥65 岁的老年人成功的 PCP 干预措施中使用的 BCT。

设计和设置

系统评价。

方法

作者从成立日期到 2017 年 9 月 30 日搜索了 12 个数据库。他们确定了涉及年龄≥65 岁的参与者并与 PCP 相关的干预措施的随机对照试验(RCT)。评估了五个方面的偏倚风险。使用 Michie BCT 分类法进行编码。

结果

23 项 RCT 涉及 6489 名参与者(平均年龄 74 岁),描述了针对一般老年人群体和特定慢性疾病(如心脏病、糖尿病、中风)老年人的 PCP 干预措施。只有一半左右的研究被认为是低偏倚风险的。在五项报告生活质量(QoL)显著改善的研究中,确定了 11 种“有前途”的 BCT。在这五项研究中均报告了六种 BCT:“目标设定”、“行动计划”、“解决问题”、“社会支持”、“关于如何执行行为的说明”和“有关健康后果的信息”。交付方式多种多样。

结论

未来改善年龄≥65 岁人群 QoL 的 PCP 干预措施可能受益于专注于六种特定的 BCT。更好地报告 BCT 将增强此类干预措施的未来设计和实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfaf/7846358/2facb048dc68/bjgpfeb-2021-71-703-heaven-1.jpg

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