埃塞俄比亚2型糖尿病患者良好自我护理实践的系统评价与荟萃分析：加强生活方式改变的全国呼吁
Systematic Review and Meta-Analysis of Good Self-Care Practice among People Living with Type 2 Diabetes Mellitus in Ethiopia: A National Call to Bolster Lifestyle Changes.
作者信息
Dagnew Baye, Debalkie Demissie Getu, Abebaw Angaw Dessie
机构信息
Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
Department of Health Promotion and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
出版信息
Evid Based Complement Alternat Med. 2021 Feb 20;2021:8896896. doi: 10.1155/2021/8896896. eCollection 2021.
BACKGROUND
Self-care practice is the mainstay of management for good glycemic control. Despite the presence of a few pocket studies, no comprehensive study was conducted in Ethiopia to demonstrate the overall good self-care practice among diabetic patients in Ethiopia. Therefore, we intended to conduct this systematic review and meta-analysis to estimate the overall good self-care practice among people living with type 2 diabetes mellitus (T2DM) in Ethiopia.
METHODS
We systematically searched PubMed, Scopus, Science Direct, Cochrane library, Google scholar, and direct Google to retrieve relevant studies. Forest plot was used to present the pooled estimate of good self-care practice using DerSimonian and Laird's random-effects model. We checked publication bias using Egger's test and funnel plot. Potential heterogeneity was tested using the I-squared statistic. Moreover, subgroup and sensitivity analyses were performed.
RESULTS
In this review, 12 primary studies (with a total sample size of 4030) were included. Because of the presence of heterogeneity, we employed a random-effects model. After running the random-effects model, the pooled estimate of overall good self-care practice was 51.12% (95% CI: 41.90-60.34). Furthermore, the pooled estimate of good dietary practice was 50.18% (95% CI: 32.75-67.60), good physical exercise practice was 48.29% (95% CI: 34.14-62.43), the good footcare practice was 63.61% (95% CI: 45.56-81.66), and appropriate self-monitoring of the blood glucose level was 31.89% (95% CI: -4.62-68.41). In this meta-analysis, there was serious interstudy variation, but there was no publication bias.
CONCLUSIONS
The overall good self-care practice among people living with T2DM was low which necessitates the need for designing strategies to increase the self-care practice. The health sector has to bolster awareness creation to allow better plasma glucose control and preventing diabetes-related complications. This trial is registered with CRD42019147694.
背景
自我护理实践是实现良好血糖控制管理的主要手段。尽管有一些小规模研究，但埃塞俄比亚尚未开展全面研究以证明该国糖尿病患者的整体自我护理实践情况良好。因此，我们旨在进行这项系统评价和荟萃分析，以评估埃塞俄比亚2型糖尿病（T2DM）患者的整体自我护理实践情况。
方法
我们系统检索了PubMed、Scopus、科学Direct、Cochrane图书馆、谷歌学术以及直接在谷歌上检索，以获取相关研究。森林图用于呈现使用DerSimonian和Laird随机效应模型得出的良好自我护理实践的合并估计值。我们使用Egger检验和漏斗图检查发表偏倚。使用I²统计量检验潜在异质性。此外，还进行了亚组分析和敏感性分析。
结果
在本评价中，纳入了12项原始研究（总样本量为4030）。由于存在异质性，我们采用了随机效应模型。运行随机效应模型后，良好自我护理实践的合并估计值为51.12%（95%置信区间：41.90 - 60.34）。此外，良好饮食实践的合并估计值为50.18%（95%置信区间：32.75 - 67.60），良好体育锻炼实践的合并估计值为48.29%（95%置信区间：34.14 - 62.43），良好足部护理实践的合并估计值为63.61%（95%置信区间：45.56 - 81.66），血糖水平的适当自我监测为31.89%（95%置信区间： - 4.62 - 68.41）。在这项荟萃分析中，研究间存在严重差异，但不存在发表偏倚。
结论
T2DM患者的整体自我护理实践情况良好率较低，这就需要制定策略来提高自我护理实践。卫生部门必须加强宣传，以实现更好的血糖控制并预防糖尿病相关并发症。本试验已在CRD42019147694注册。
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