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六十年关于患者教育对健康效果的研究综述:二阶荟萃分析。

What sixty years of research says about the effectiveness of patient education on health: a second order meta-analysis.

机构信息

Department of Educational Psychology, University of Trier, Trier, Germany.

University of Tübingen, Tübingen, Germany.

出版信息

Health Psychol Rev. 2022 Sep;16(3):450-474. doi: 10.1080/17437199.2021.1967184. Epub 2021 Aug 24.

Abstract

Although meta-analyses have examined the association between patient education and health, the validity and quality of this evidence have not been comprehensively assessed. This second order meta-analysis combined previous meta-analyses that examined the effectiveness of patient education on health outcomes as an overall weighted grand mean . Further, measures of methodological quality, meaningful variability across first order meta-analyses, and evidence for publication bias were examined. Forty meta-analyses were identified, investigating 156 associations between patient education and health summarizing data from over 776 studies including more than 74.947 patients. Quantitative analyses showed that patient education positively affects health outcomes with  = 0.316 (95% CI [0.304, 0.329]). Summarizing data exclusively from randomized controlled trials indicated a causal effect. Patient education was effective for patients with neoplasms, diabetes, mental and behavioral disorders, diseases of the circulatory system, the respiratory system, and the musculoskeletal system. Patient education was effective in the reduction of medication use, pain, and visits to medical facilities, and significantly improved physiological, physical, psychological outcomes, and patients' general function. Overall, the findings reveal firm evidence for the effectiveness of patient education on health outcomes. However, theory-based interventions are lacking and need to be implemented to enable a successful transfer from theory to practice.

摘要

虽然荟萃分析已经研究了患者教育与健康之间的关系,但该证据的有效性和质量尚未得到全面评估。本次二级荟萃分析将之前研究患者教育对健康结果影响的荟萃分析进行了合并,作为一个整体加权总平均值。此外,还评估了方法学质量、一级荟萃分析之间的有意义差异以及发表偏倚的证据。确定了 40 项荟萃分析,调查了 156 项患者教育与健康之间的关联,汇总了来自 776 多项研究的数据,其中包括超过 74947 名患者。定量分析表明,患者教育对健康结果有积极影响,=0.316(95%置信区间 [0.304,0.329])。仅汇总随机对照试验的数据表明存在因果效应。患者教育对肿瘤、糖尿病、精神和行为障碍、循环系统疾病、呼吸系统疾病和肌肉骨骼系统疾病患者有效。患者教育可有效减少用药、疼痛和就诊次数,并显著改善生理、身体、心理结果以及患者的一般功能。总体而言,这些发现为患者教育对健康结果的有效性提供了确凿的证据。然而,缺乏基于理论的干预措施,需要实施这些措施,以便将理论成功转化为实践。

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