系统评价言语病理学治疗中成年人群的依从性策略。
A Systematic Review of Adherence Strategies for Adult Populations in Speech-Language Pathology Treatment.
机构信息
Northern Arizona University, Flagstaff.
出版信息
Am J Speech Lang Pathol. 2022 May 10;31(3):1501-1516. doi: 10.1044/2022_AJSLP-21-00255. Epub 2022 Mar 23.
PURPOSE
Speech-language pathologists (SLPs) often advise adult patients to complete at-home programs in order to improve outcomes. Despite this widespread practice, relatively little is known about treatment adherence. The purposes of this systematic review were to identify adherence strategies and adherence tracking methods used by adult populations that are commonly treated by SLPs (i.e., dysphagia, aphasia, traumatic brain injury, dysphonia, dysarthria), and to identify the efficacy of these strategies.
METHOD
The systematic review was conducted in accordance with A Measurement Tool to Assess Systematic Reviews guidelines. A comprehensive literature search was performed in three databases (CINAHL, PubMed, and Web of Science).
RESULTS
Of the 679 articles found, 18 were selected for analysis. Two thirds of the included articles received the second highest rating on the 5-point JAMA Quality Rating Scheme. Interventions designed to alter treatment adherence included (most to least frequent) computer programs, portable devices/phone apps, alarm reminders, instructional DVDs, check-ins from a clinician/volunteer, and wearable device. Adherence reporting methods included (most to least frequent) self-report diaries, computer program/app-aided collection, wearable device, and clinician/volunteer observation. Of the articles that reported practice frequency, 58% found that adherence strategies improved practice frequency as compared to control. Of the articles that reported treatment outcomes, 66% found that adherence strategies were associated with improved treatment outcomes as compared to control.
CONCLUSIONS
The paucity of publications reviewed suggests that treatment adherence is considerably understudied in speech-language pathology. A clearer understanding of how to improve the design of adherence strategies could yield highly valuable clinical outcomes.
SUPPLEMENTAL MATERIAL
目的
言语-语言病理学家（SLP）经常建议成年患者完成家庭治疗方案，以改善治疗效果。尽管这种做法很普遍，但人们对治疗依从性的了解相对较少。本系统综述的目的是确定 SLP 常见治疗人群（即吞咽障碍、失语症、创伤性脑损伤、发声障碍、构音障碍）使用的依从性策略和依从性跟踪方法，并确定这些策略的效果。
方法
系统综述是按照评估系统评价的测量工具指南进行的。在三个数据库（CINAHL、PubMed 和 Web of Science）中进行了全面的文献检索。
结果
在检索到的 679 篇文章中，有 18 篇被选入分析。纳入的文章中有三分之二在 JAMA 质量评分方案的 5 分制中获得了第二高的评分。旨在改变治疗依从性的干预措施包括（从最常见到最不常见）计算机程序、便携式设备/电话应用程序、报警提醒、教学 DVD、临床医生/志愿者的定期检查以及可穿戴设备。依从性报告方法包括（从最常见到最不常见）自我报告日记、计算机程序/应用程序辅助收集、可穿戴设备和临床医生/志愿者观察。在报告实践频率的文章中，有 58%的文章发现，与对照组相比，依从性策略提高了实践频率。在报告治疗结果的文章中，有 66%的文章发现，与对照组相比，依从性策略与改善治疗结果相关。
结论
本研究回顾的文献很少，这表明在言语-语言病理学中，治疗依从性的研究相当不足。更清楚地了解如何改进依从性策略的设计可能会产生非常有价值的临床结果。
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