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医患关系对1型糖尿病儿童治疗结果的影响:一项荟萃分析与系统评价

Impact of the Patient-Doctor Relationship on Treatment Outcomes in Children with Type 1 Diabetes: A Meta-Analysis and Systematic Review.

作者信息

Stefanescu Cristina, Boroi Denisa, Iacob Claudia Iuliana, Stefanescu Victorița, Nechita Aurel

机构信息

Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, 800010 Galați, Romania.

Faculty of Psychology and Educational Sciences, University of Bucharest, 050663 Bucharest, Romania.

出版信息

Children (Basel). 2024 Aug 26;11(9):1041. doi: 10.3390/children11091041.


DOI:10.3390/children11091041
PMID:39334574
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11430008/
Abstract

(1) Background: Despite the recognized importance of the patient-doctor relationship (PDR) for pediatric diabetes management, the literature presents diverse and emerging findings regarding its impact on treatment outcomes for children with type 1 diabetes (T1D). (2) Methods: Using a meta-analytic approach, a comprehensive search for relevant studies was conducted across major databases, from the earliest study to June 2024. Inclusion criteria were studies on PDR and T1D outcomes in underaged individuals, providing quantitative results. (3) Results: Fifteen reports were included, showing a small but significant overall effect size (r = 0.165, < 0.05) of PDR on T1D outcomes. Moderator analyses revealed significant associations from elements of PDR, duration of diagnosis, outcome assessment methods, information reporters, and being Caucasian. Demographic variables like gender, age, not being Caucasian, and caregiver's marital status did not significantly impact the association. Specific elements of PDR, such as clinician's objectives, communication, partnership, respect, and supportive care, showed significant positive effect sizes, while telecommunication did not. (4) Conclusions: A strong PDR is essential for managing diabetes in children, particularly in the early years of diagnosis. Future studies should use quantitative designs and include diverse demographics to better understand PDR's connection to T1D outcomes.

摘要

(1) 背景:尽管医患关系(PDR)对儿童糖尿病管理的重要性已得到认可,但关于其对1型糖尿病(T1D)患儿治疗结果的影响,文献中呈现出多样且不断涌现的研究结果。(2) 方法:采用荟萃分析方法,对主要数据库进行了全面检索,涵盖从最早的研究到2024年6月的相关研究。纳入标准为关于未成年个体中PDR与T1D结果的研究,并提供定量结果。(3) 结果:纳入了15份报告,显示PDR对T1D结果有小但显著的总体效应量(r = 0.165,P < 0.05)。调节分析揭示了PDR要素、诊断时长、结果评估方法、信息报告者以及白种人身份之间存在显著关联。性别、年龄、非白种人以及照顾者婚姻状况等人口统计学变量对这种关联没有显著影响。PDR的具体要素,如临床医生的目标、沟通、伙伴关系、尊重和支持性护理,显示出显著的正向效应量,而远程通信则没有。(4) 结论:良好的医患关系对于儿童糖尿病管理至关重要,尤其是在诊断后的早期阶段。未来的研究应采用定量设计,并纳入多样化的人口统计学数据,以更好地理解医患关系与T1D结果之间的联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06ce/11430008/28068ba7e9f5/children-11-01041-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06ce/11430008/315bfa37cd8c/children-11-01041-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06ce/11430008/b4b4fd512c46/children-11-01041-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06ce/11430008/28068ba7e9f5/children-11-01041-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06ce/11430008/315bfa37cd8c/children-11-01041-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06ce/11430008/b4b4fd512c46/children-11-01041-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06ce/11430008/28068ba7e9f5/children-11-01041-g003.jpg

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Impact of the Patient-Doctor Relationship on Treatment Outcomes in Children with Type 1 Diabetes: A Meta-Analysis and Systematic Review.

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本文引用的文献

[1]
Brief acceptance and commitment therapy for children and adolescents with type 1 diabetes.

Front Psychol. 2024-6-26

[2]
Intervention to promote adolescents' communication and engagement in diabetes clinic encounters: A pilot randomized controlled trial.

Patient Educ Couns. 2024-9

[3]
Beyond Therapeutic Adherence: Alternative Pathways for Understanding Medical Treatment in Type 1 Diabetes Mellitus.

Int J Environ Res Public Health. 2024-3-9

[4]
The biopsychosociotechnical model: a systems-based framework for human-centered health improvement.

Health Syst (Basingstoke). 2022-1-30

[5]
Death anxiety in connection to anxiety and depressive disorders: A meta-analysis on emotional distress in clinical and community samples.

Death Stud. 2024

[6]
Psychological variables and lifestyle in children with type1 diabetes and their parents: A systematic review.

Clin Child Psychol Psychiatry. 2024-7

[7]
Primary healthcare competencies needed in the management of person-centred integrated care for chronic illness and multimorbidity: Results of a scoping review.

BMC Prim Care. 2023-4-12

[8]
Type 1 Diabetes Mellitus and Autoimmune Diseases: A Critical Review of the Association and the Application of Personalized Medicine.

J Pers Med. 2023-2-26

[9]
Involving children and adolescents with type 1 diabetes in health care: a qualitative study of the use of patient-reported outcomes.

J Patient Rep Outcomes. 2023-3-2

[10]
ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes.

Pediatr Diabetes. 2022-12

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