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行为干预对高血压患者患者激活的影响:系统评价和荟萃分析。

Impact of Behavioral Interventions on Patient Activation in Adults with Hypertension: A Systematic Review and Meta-Analysis.

机构信息

Nursing Administration and Education, 108790King Saud University College of Nursing, Riyadh, Saudi Arabia.

出版信息

Inquiry. 2022 Jan-Dec;59:469580221090408. doi: 10.1177/00469580221090408.

Abstract

Behavioral interventions assist patients in maintaining optimal self-management of their health, especially in those at risk of certain conditions. Little is known about the effects of self-management interventions on patient activation in adults with hypertension. Therefore, this systematic review and meta-analysis aimed to evaluate how self-management strategies affect changes in activation levels in adults with hypertension. We searched online databases: PubMed, CINAHL, and Cochrane Central Register of Controlled Trials for studies published between January 2004 and May 2021. We included randomized controlled trials that assessed the effects of self-management interventions on patient activation in adults with hypertension and reported patient activation using the patient activation measure (PAM). 4 Four studies (N = 1415 participants) met the inclusion criteria. In adults with hypertension, self-management interventions improved patient activation with moderate strength of evidence. A community-based self-management program, motivational interviewing strategies, and home-based patient-activated care were associated with better PAM scores than usual care. Our findings reinforce the need for healthcare providers to incorporate these interventions into primary care to support the adoption of recommended hypertension self-management behaviors. Future studies must focus on tailoring support to the patient's level of activation in hypertension self-management.

摘要

行为干预可帮助患者维持对其健康的最佳自我管理,特别是对某些疾病高危人群而言。目前对于自我管理干预对高血压患者的患者激活水平的影响知之甚少。因此,本系统评价和荟萃分析旨在评估自我管理策略如何影响高血压患者的激活水平变化。我们检索了在线数据库:PubMed、CINAHL 和 Cochrane 对照试验中心注册库,以获取 2004 年 1 月至 2021 年 5 月发表的研究。我们纳入了评估自我管理干预对高血压患者的患者激活影响的随机对照试验,并使用患者激活测量工具(PAM)报告患者激活。四项研究(N=1415 名参与者)符合纳入标准。在高血压患者中,自我管理干预以中等强度的证据改善了患者的激活水平。基于社区的自我管理计划、动机性访谈策略和基于家庭的患者激活护理与常规护理相比,与更好的 PAM 评分相关。我们的研究结果强调了医疗保健提供者将这些干预措施纳入初级保健的必要性,以支持采用推荐的高血压自我管理行为。未来的研究必须专注于根据高血压自我管理中患者的激活水平为其提供个性化支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32e3/9152571/909521700948/10.1177_00469580221090408-fig1.jpg

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