School of Nursing, Jilin University, Changchun, Jilin, China.
Department of Endocrinology and Metabolism, Eastern Division of the First Bethune Hospital of Jilin University, Changchun, China.
BMJ Open. 2022 Jan 6;12(1):e055329. doi: 10.1136/bmjopen-2021-055329.
The effectiveness of integrating message framing into educational interventions to promote the health behaviour of patients with chronic diseases is still being debated in nursing research. The objective of this study was to assess the impact of educational interventions based on gain and loss frames on the health behaviours and beliefs of patients with chronic diseases and to identify the frame that achieves better outcomes.
The systematic review was based on PRISMA guidelines for comprehensively searching, appraising and synthesising research evidence.
We searched the PubMed, Web of Science, PsycINFO and CINAHL databases for reports published from database inception until 26 March 2021.
Intervention studies, published in English, with adult patients with chronic disease conditions, and with intervention contents involved in the implementation of message framing, were considered. The outcomes were health behaviours or beliefs, such as knowledge, self-efficacy, intention or attitudes.
Data extraction and entry were performed using a predesigned data extraction form and assessed independently by two reviewers using the Cochrane Collaboration Risk of Bias I.
A total of 11 intervention studies were included. We found that educational intervention based on both gain and loss frames could enhance the positive effects of communication, and promote healthy behaviours and beliefs in patients with chronic disease. Many of the studies we included here showed the advantage of loss framing messages. Due to the limited number of articles included and without quantitative analysis, this result should be interpreted cautiously.
Integrating message framing into health education might be a promising strategy to motivate patients with chronic disease to improve their health behaviours and beliefs. More extensive and well-designed trials are needed to support the conclusions and discuss the effective framing, moderators and mediators of framing.
CRD42021250931.
在护理研究中，将信息框架整合到教育干预中以促进慢性病患者健康行为的有效性仍存在争议。本研究旨在评估基于收益和损失框架的教育干预对慢性病患者健康行为和信念的影响，并确定哪种框架能取得更好的效果。
系统评价基于 PRISMA 指南，全面搜索、评估和综合研究证据。
我们检索了 PubMed、Web of Science、PsycINFO 和 CINAHL 数据库，检索时间截至 2021 年 3 月 26 日。
纳入研究为干预性研究，发表于英文期刊，研究对象为成年慢性病患者，干预内容涉及信息框架的实施。结局指标为健康行为或信念，如知识、自我效能、意向或态度。
使用预先设计的数据提取表进行数据提取和录入，由两名评审员独立评估，使用 Cochrane 协作风险偏倚工具 I 进行评估。
共纳入 11 项干预研究。我们发现，基于收益和损失框架的教育干预可以增强沟通的积极效果，促进慢性病患者的健康行为和信念。我们纳入的许多研究都显示出损失框架信息的优势。由于纳入的文章数量有限，且未进行定量分析，因此该结果应谨慎解释。
将信息框架整合到健康教育中可能是激励慢性病患者改善健康行为和信念的一种有前途的策略。需要进行更广泛和精心设计的试验来支持这一结论，并讨论有效的框架、框架的调节因素和中介因素。
PROSPERO 注册号：CRD42021250931。
