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慢性阻塞性肺疾病患者中动机性访谈的效果:系统评价与随机对照试验的荟萃分析和序贯分析。

Effectiveness of motivational interviewing among patients with COPD: A systematic review with meta-analysis and trial sequential analysis of randomized controlled trials.

机构信息

School of Nursing, Nanjing Medical University, Nanjing, China.

School of Nursing, Nanjing Medical University, Nanjing, China; Department of Respiratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Patient Educ Couns. 2022 Nov;105(11):3174-3185. doi: 10.1016/j.pec.2022.07.019. Epub 2022 Jul 28.

Abstract

OBJECTIVE

To evaluate the effectiveness of motivational interviewing (MI) for COPD in behavioral changes and health outcomes, and also verify the reliability of results in conjunction with trial sequential analysis and the Grading of Recommendations Assessment, Development, and Evaluation tool.

METHODS

Studies that implemented MI interventions for COPD patients were systematically searched by eight databases from inception to December 2021. Study screening, quality assessment, data extraction, and meta-analysis were conducted according to Cochrane standards.

RESULTS

Twenty-one studies involving 2344 patients were included. The results of meta-analyses indicated that MI made significant improvement in self-efficacy, lung function, quality of life, emotion, and COPD-related admission, but not in self-management and exercise capacity. Subgroup analyses found that the intervention duration was inversely associated with effect size for both self-efficacy and negative emotion severity. The trial sequential analysis showed MI improved patients' lung function and reduced COPD-related hospitalization with certainty, but the findings for exercise capacity need to be confirmed by further research.

CONCLUSIONS

This systematic review suggested the positive effects of MI on self-efficacy, lung function, quality of life, emotion and COPD-related hospitalization. To make a firm conclusion, more well-designed clinical trials with bigger sample sizes required.

PRACTICE IMPLICATIONS

Clinical and community nurses can use MI for COPD to increase healthy behaviors.

TRIAL REGISTRATION

CRD42021278674.

摘要

目的

评估动机性访谈(MI)在 COPD 行为改变和健康结果方面的有效性,并结合试验序贯分析和推荐评估、制定与评估工具(Grading of Recommendations Assessment, Development, and Evaluation tool)验证结果的可靠性。

方法

通过 8 个数据库系统地检索了从建库到 2021 年 12 月实施 MI 干预 COPD 患者的研究。根据 Cochrane 标准进行研究筛选、质量评估、数据提取和荟萃分析。

结果

共纳入 21 项研究,涉及 2344 例患者。荟萃分析结果表明,MI 显著改善了自我效能、肺功能、生活质量、情绪和 COPD 相关住院率,但对自我管理和运动能力没有影响。亚组分析发现,干预持续时间与自我效能和负面情绪严重程度的效应大小呈负相关。试验序贯分析表明 MI 能改善患者的肺功能并降低 COPD 相关住院率,但运动能力的研究结果需要进一步研究确认。

结论

本系统评价表明 MI 对自我效能、肺功能、生活质量、情绪和 COPD 相关住院率有积极影响。需要更多设计良好、样本量大的临床试验来得出确切结论。

实践意义

临床和社区护士可以使用 MI 来促进 COPD 患者的健康行为。

注册

CRD42021278674。

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