Thirsk Lorraine M, Schick-Makaroff Kara
Faculty of Health Disciplines, Athabasca University, Athabasca, Canada.
Faculty of Nursing, University of Alberta, Edmonton, Canada.
Patient Educ Couns. 2021 Dec;104(12):2890-2899. doi: 10.1016/j.pec.2021.04.037. Epub 2021 May 5.
Review and synthesize qualitative research on family interventions for adults living with type 2 diabetes.
A qualitative metasynthesis was conducted. Analysis used imported concepts from realist evaluation - context, mechanisms, and outcomes.
Six studies met inclusion criteria in this qualitative systematic review. Powerful mechanisms were identified that occur outside the family intervention in the context of ethnic, racialized, and geographically defined groups. Many similarities were noted across contexts, such as low income. Mechanisms of interventions focused primarily on family member education. Outcomes were focused more on improving self-care behaviors, rather than family-oriented outcomes.
Systemic issues affecting social determinants of health set the context for family interventions for type 2 diabetes. When designing these interventions, intersectionality, scarcity, and family functioning may need to be considered.
Emphasis on education of family members may not be effective in improving diabetes outcomes, as many powerful mechanisms exist outside of these interventions.
回顾并综合关于针对成年2型糖尿病患者的家庭干预措施的定性研究。
进行了一项定性元分析。分析采用了现实主义评价中的导入概念——背景、机制和结果。
六项研究符合该定性系统评价的纳入标准。确定了在族裔、种族化和地理界定群体背景下家庭干预之外发生的有力机制。不同背景下存在许多相似之处，如低收入。干预机制主要侧重于家庭成员教育。结果更多地侧重于改善自我护理行为，而非以家庭为导向的结果。
影响健康社会决定因素的系统性问题为2型糖尿病的家庭干预设定了背景。在设计这些干预措施时，可能需要考虑交叉性、资源稀缺和家庭功能。
强调家庭成员教育可能无法有效改善糖尿病结局，因为在这些干预措施之外存在许多有力机制。
