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患者决策辅助工具对 2 型糖尿病患者的影响:系统评价和荟萃分析。

Effects of patient decision aids in patients with type 2 diabetes mellitus: A systematic review and meta-analysis.

机构信息

School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China.

Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Center for Evidence-Based and Translational Medicine, Wuhan University, Hubei, China.

出版信息

Int J Nurs Pract. 2021 Dec;27(6):e12914. doi: 10.1111/ijn.12914. Epub 2021 Mar 3.

Abstract

AIMS

This study aimed to systematically evaluate the effectiveness of patient decision aids on knowledge, decisional conflict and decisional self-efficacy outcomes in patients with diabetes.

METHODS

A comprehensive database search was performed using the Web of Science, Cochrane Library, PubMed, Embase, PsycINFO (Ovid), CINAHL (EBASCO), CNKI, VIP, Wan Fang Database and the Ottawa Decision Aid Library Inventory (http://decisionaid.ohri.ca/index.html) from inception to 13 October 2019. Two reviewers independently searched databases, screened articles, extracted data and evaluated the risk bias of included studies. Then Rev Man 5.3 software was adopted for statistical analysis.

RESULTS

Ten articles containing 1,452 people with diabetes were selected. The results of meta-analysis showed that patient decision aids had a positive effect on reducing decisional conflict and improving decisional self-efficacy among patients with type 2 diabetes. Meanwhile, this article also revealed that patient decision aids have beneficial short-term effects on improving knowledge, but there was no significant long-term effect.

CONCLUSION

Patient decision aids are capable of becoming support tools to improve shared decision making. Further implementation studies are required to transform patient decision aids tools into clinical practice.

摘要

目的

本研究旨在系统评价患者决策辅助工具在糖尿病患者的知识、决策冲突和决策自我效能方面的效果。

方法

从建库到 2019 年 10 月 13 日,我们使用 Web of Science、Cochrane 图书馆、PubMed、Embase、PsycINFO(Ovid)、CINAHL(EBASCO)、CNKI、VIP、万方数据库和渥太华决策辅助工具清单(http://decisionaid.ohri.ca/index.html)全面检索数据库。两位评审员独立检索数据库、筛选文章、提取数据并评估纳入研究的偏倚风险。然后采用 Rev Man 5.3 软件进行统计分析。

结果

共纳入 10 篇文章,包含 1452 例糖尿病患者。荟萃分析结果显示,患者决策辅助工具对降低 2 型糖尿病患者的决策冲突和提高决策自我效能具有积极作用。同时,本文还表明,患者决策辅助工具对提高知识具有短期有益效果,但没有显著的长期效果。

结论

患者决策辅助工具能够成为改善共同决策的支持工具。需要进一步开展实施研究,将患者决策辅助工具转化为临床实践。

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