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动机性访谈对糖尿病患者代谢控制和心理社会变量的影响:系统评价和荟萃分析。

The effect of motivational interviewing on metabolic control and psychosocial variables in individuals diagnosed with diabetes: Systematic review and meta-analysis.

机构信息

Hacettepe University, Faculty of Nursing, Internal Medicine Nursing Department, Ankara, Turkey.

Nevsehir Haci Bektas Veli University, Department of Internal Medicine Nursing, Nevsehir, Turkey.

出版信息

Patient Educ Couns. 2022 Sep;105(9):2806-2823. doi: 10.1016/j.pec.2022.04.008. Epub 2022 Apr 18.

Abstract

OBJECTIVE

The current study aimed to analyze the effects of motivational interviewing (MI) on metabolic and psychosocial variables among individuals with diabetes.

METHODS

Four databases were searched between 2000 and 2021 years. Randomized controlled studies were included. The standardized mean differences were determined. The heterogeneity was analyzed using the I test. The methodological quality was evaluated independently by three researchers.

RESULTS

This meta-analysis included 16 studies. Glycated hemoglobin, postprandial plasma glucose (PG), systolic blood pressure (BP) significantly decreased after MI. There are no significant effects of MI on fasting PG, body mass index, diastolic BP, total cholesterol, high-density lipoprotein, low-density lipoprotein and triglyceride. MI had an overall significant impact on depression, emotional distress, and self-efficacy. Only four studies had 7 points based on the Modified Jadad Scale. The Egger's test showed no evidence of publication bias.

CONCLUSION

MI effectively reduced glycated hemoglobin, postprandial plasma glucose, systolic blood pressure, depressive symptoms, emotional distress, and increased self-efficacy.

PRACTICE IMPLICATIONS

This meta-analysis showed that MI was effective at improving metabolic control and psychosocial variables. MI should be considered a complementary treatment for people diagnosed with diabetes. Future studies should be structured as long-term studies with higher methodological quality.

摘要

目的

本研究旨在分析动机性访谈(MI)对糖尿病患者代谢和心理社会变量的影响。

方法

在 2000 年至 2021 年间检索了四个数据库。纳入随机对照研究。确定标准化均数差。使用 I 检验分析异质性。三位研究人员独立评估方法学质量。

结果

本荟萃分析纳入了 16 项研究。MI 后糖化血红蛋白、餐后血浆葡萄糖(PG)、收缩压(BP)显著降低。MI 对空腹 PG、体重指数、舒张压、总胆固醇、高密度脂蛋白、低密度脂蛋白和甘油三酯没有显著影响。MI 对抑郁、情绪困扰和自我效能感有整体显著影响。只有四项研究的改良 Jadad 量表评分为 7 分。Egger 检验表明不存在发表偏倚的证据。

结论

MI 能有效降低糖化血红蛋白、餐后 PG、收缩压、抑郁症状、情绪困扰和提高自我效能感。

实践意义

本荟萃分析表明,MI 对改善代谢控制和心理社会变量有效。MI 应被视为糖尿病患者的一种补充治疗方法。未来的研究应设计为具有更高方法学质量的长期研究。

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