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动机性访谈对高血压管理的影响:系统评价和荟萃分析。

The effects of motivational interviewing on hypertension management: A systematic review and meta-analysis.

机构信息

School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, China.

Department of Pharmacy, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.

出版信息

Patient Educ Couns. 2023 Jul;112:107760. doi: 10.1016/j.pec.2023.107760. Epub 2023 Apr 14.

Abstract

OBJECTIVE

This systematic review aimed to examine the effects of motivational interviewing-based interventions on hypertension management.

METHODS

Six databases were searched from inception to 25 July, 2022 for randomized controlled trials involving adults diagnosed with hypertension and including motivational interviewing in the treatment interventions.

RESULTS

In total, 11 studies with 2121 participants were included. Compared with no or minimal additional intervention, motivational interviewing-based intervention showed greater reduction in systolic blood pressure (MD: -6.56, 95 % CI: -10.51, -2.62, P = 0.001) and diastolic blood pressure (MD: -3.75, 95 % CI: -4.92, -2.58, P < 0.001). Compared with the lower intensity intervention, motivational interviewing-based intervention produced statistically significant effect on reducing systolic blood pressure (MD: -2.72, 95 % CI: -5.34, -0.10, P = 0.040); while there was no significant effect on reducing diastolic blood pressure (MD: -0.47, 95 % CI: -2.21, 1.28, P = 0.600). Four out of six studies demonstrated medication adherence significantly improved following motivational interviewing-based intervention. Two studies included self-efficacy and quality of life, and inconsistent findings were observed.

CONCLUSION

Motivational interviewing could be effective in improving blood pressure control among patients with hypertension. Future studies with more rigorous study designs should be conducted to confirm the effects of motivational interviewing on medication adherence and psychological well-being.

PRACTICE IMPLICATIONS

Motivational interviewing could be applied as a promising intervention strategy among patients with hypertension.

摘要

目的

本系统评价旨在考察基于动机访谈的干预措施对高血压管理的影响。

方法

从建库至 2022 年 7 月 25 日,检索了 6 个数据库,纳入了包含高血压诊断成年人且治疗干预中包含动机访谈的随机对照试验。

结果

共纳入 11 项研究,涉及 2121 名参与者。与无或最小附加干预相比,基于动机访谈的干预可使收缩压(MD:-6.56,95%CI:-10.51,-2.62,P=0.001)和舒张压(MD:-3.75,95%CI:-4.92,-2.58,P<0.001)显著降低。与较低强度的干预相比,基于动机访谈的干预对降低收缩压具有统计学意义(MD:-2.72,95%CI:-5.34,-0.10,P=0.040);而对降低舒张压没有显著影响(MD:-0.47,95%CI:-2.21,1.28,P=0.600)。6 项研究中有 4 项表明,基于动机访谈的干预后药物依从性显著提高。有两项研究纳入了自我效能和生活质量,观察到结果不一致。

结论

动机访谈可有效改善高血压患者的血压控制。未来应开展更多设计严谨的研究来证实动机访谈对药物依从性和心理健康的影响。

实践意义

动机访谈可以作为高血压患者有前途的干预策略。

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