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影响2型糖尿病少数民族患者采用文化定制糖尿病自我管理教育与支持项目的因素:一项系统综述

Factors influencing the uptake of culturally tailored diabetes self-management education and support programmes among ethnic minority patients with type 2 diabetes: A systematic review.

作者信息

Abu Sariata, Llahana Sofia

机构信息

Tulasi Medical Centre, 10 Bennett's Castle Ln, Dagenham RM8 3XU, United Kingdom.

School of Health & Medical Sciences, City St George's, University of London, London, United Kingdom.

出版信息

Prim Care Diabetes. 2025 Apr;19(2):103-110. doi: 10.1016/j.pcd.2025.01.010. Epub 2025 Feb 1.

Abstract

PURPOSE

This systematic review aimed to evaluate the factors influencing the uptake of culturally-tailored Diabetes Self-Management Education and Support (DSMES) programmes among ethnic minority patients diagnosed with type 2 diabetes mellitus (T2DM).

METHODS

A systematic review, following PRISMA guidelines, was conducted, including quantitative research studies published in peer-reviewed journals from January 2013 to January 2023. Studies were extracted via the following databases, AMED, MEDLINE, CINAHL, EMBASE, EMCARE, PSYCHINFO, Ovid Nursing, and grey literature. Studies were selected based on eligibility criteria including the evaluation of DSMES programmes tailored for ethnic minorities and involving adult participants with T2DM. The factors affecting the uptake of these programs were mapped against the three categories of the Andersen's Behavioural Model of Health Services Use: predisposing, enabling, and need factors. The quality of the included studies was assessed using the Critical Appraisal Skills Program (CASP) checklist, and a narrative synthesis was conducted to analyse the findings.

RESULTS

Nine studies met the inclusion criteria, demonstrating that culturally-tailored DSMES programmes significantly improve uptake among ethnic minorities. Key factors influencing participation included demographic characteristics, diabetes knowledge, emotional support, and cultural beliefs. Barriers such as language proficiency, cost, and diabetes fatalism were identified, while enablers included the use of local champions and culturally specific strategies.

CONCLUSIONS

This systematic review highlights the effectiveness of culturally-tailored DSMES programmes in improving health outcomes among ethnic minority groups. It suggests that more research is needed to explore these barriers and develop strategies to enhance the uptake of DSMES programmes among underserved populations.

摘要

目的

本系统评价旨在评估影响为被诊断为2型糖尿病(T2DM)的少数民族患者量身定制的糖尿病自我管理教育与支持(DSMES)项目接受度的因素。

方法

按照PRISMA指南进行系统评价,纳入2013年1月至2023年1月在同行评审期刊上发表的定量研究。通过以下数据库提取研究:AMED、MEDLINE、CINAHL、EMBASE、EMCARE、PSYCHINFO、Ovid Nursing以及灰色文献。根据纳入标准选择研究,纳入标准包括对为少数民族量身定制的DSMES项目进行评估,且涉及成年T2DM患者。将影响这些项目接受度的因素与安德森卫生服务利用行为模型的三个类别进行映射:易患因素、促成因素和需求因素。使用批判性评价技能计划(CASP)清单评估纳入研究的质量,并进行叙述性综合分析结果。

结果

九项研究符合纳入标准,表明量身定制的DSMES项目显著提高了少数民族的接受度。影响参与的关键因素包括人口统计学特征、糖尿病知识、情感支持和文化信仰。识别出语言能力、成本和糖尿病宿命论等障碍,而促成因素包括使用当地倡导者和特定文化策略。

结论

本系统评价强调了量身定制的DSMES项目在改善少数民族健康结局方面的有效性。这表明需要更多研究来探索这些障碍,并制定策略以提高在服务不足人群中DSMES项目的接受度。

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