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自我管理干预对系统性红斑狼疮患者行为和临床结局的影响:对2003年至2024年实证证据的系统评价

The Impact of Self-Management Interventions on Behavioral and Clinical Outcomes in Individuals with Systemic Lupus Erythematosus: A Systematic Review of Empirical Evidence From 2003-2024.

作者信息

Hanrop Sirikarn, Narupan Nirunya, Praha Nattaya, Phianhasin Lalipat, Ruksakulpiwat Suebsarn

机构信息

Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand.

Department of Mental Health and Psychiatric Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand.

出版信息

Patient Prefer Adherence. 2025 Jun 17;19:1763-1779. doi: 10.2147/PPA.S521546. eCollection 2025.

Abstract

AIM

To evaluate and synthesize evidence on the impact of self-management interventions in improving behavioral and clinical outcomes among individuals with systemic lupus erythematosus (SLE).

METHODS

A comprehensive search was conducted across eight electronic databases-CINAHL Plus with Full Text, ProQuest, PubMed, Medline with Full Text, SAGE, ScienceDirect, Scopus, and Web of Science-to identify studies published from inception to 2024. Randomized controlled trials and quasi-experimental studies assessing self-management interventions in individuals with SLE were included. Methodological quality was evaluated using the Joanna Briggs Institute critical appraisal tools. Data synthesis followed a convergent integrated analysis framework to identify recurring themes and subthemes.

RESULTS

A total of 15 studies met the inclusion criteria, consisting of 10 randomized controlled trials (66.67%) and 5 quasi-experimental studies (33.33%). The interventions targeted physical, mental, and behavioral health through various strategies. The most common interventions included counseling and education (7 studies, 22.58%), followed by physical activity programs (2 studies, 6.45%), and self-management sessions (2 studies, 6.45%). Other interventions, such as cognitive-behavioral therapy, strengthening exercises, and digital health tools, were also implemented. In-person interventions (46.67%) were the most common delivery format, followed by digital platforms (26.67%). Self-management interventions led to significant improvements in physical health (eg, reduced fatigue and improved functional capacity), mental health (eg, reduced anxiety and depression), and health behaviors (eg, enhanced adherence to treatment and self-care practices). Furthermore, the interventions contributed to an improved quality of life by addressing the physical, psychological, and social challenges faced by individuals with SLE.

CONCLUSION

Self-management interventions positively impact behavioral and clinical outcomes in individuals with SLE. Future research should explore long-term sustainability, integration of digital health strategies, and personalized approaches. Expanding access to self-management programs, particularly in low-resource settings, may further enhance outcomes for individuals with SLE.

摘要

目的

评估并综合关于自我管理干预措施对系统性红斑狼疮(SLE)患者行为和临床结局影响的证据。

方法

对八个电子数据库进行全面检索,包括CINAHL Plus全文数据库、ProQuest、PubMed、Medline全文数据库、SAGE、ScienceDirect、Scopus和Web of Science,以识别从数据库建立至2024年发表的研究。纳入评估SLE患者自我管理干预措施的随机对照试验和准实验研究。使用乔安娜·布里格斯研究所的批判性评价工具评估方法学质量。数据综合遵循收敛性综合分析框架,以识别反复出现的主题和子主题。

结果

共有15项研究符合纳入标准,其中包括10项随机对照试验(66.67%)和5项准实验研究(33.33%)。干预措施通过各种策略针对身体、心理和行为健康。最常见的干预措施包括咨询和教育(7项研究,22.58%),其次是体育活动计划(2项研究,6.45%)和自我管理课程(2项研究,6.45%)。还实施了其他干预措施,如认知行为疗法、强化锻炼和数字健康工具。面对面干预(46.67%)是最常见的实施形式,其次是数字平台(26.67%)。自我管理干预措施使身体健康(如疲劳减轻和功能能力改善)、心理健康(如焦虑和抑郁减轻)和健康行为(如治疗依从性和自我护理实践增强)得到显著改善。此外,这些干预措施通过解决SLE患者面临的身体、心理和社会挑战,有助于提高生活质量。

结论

自我管理干预措施对SLE患者的行为和临床结局有积极影响。未来的研究应探索长期可持续性、数字健康策略的整合以及个性化方法。扩大自我管理计划的可及性,特别是在资源匮乏的环境中,可能会进一步改善SLE患者的结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b0e/12182245/fb672f2adef7/PPA-19-1763-g0001.jpg

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