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数字工具在糖尿病患者护理中的应用:范围综述

Application of Digital Tools in the Care of Patients With Diabetes: Scoping Review.

作者信息

Yan Yan, Li Na, Tian Chun

机构信息

School of Nursing, Shanxi Medical University, Taiyuan, China.

Department of Stomatology, First Hospital of Shanxi Medical University, No. 85, Jiefang South Road, Yingze District, Shanxi Province, Taiyuan, 030001, China, 86 1-383-461-1446.

出版信息

J Med Internet Res. 2025 Aug 19;27:e72167. doi: 10.2196/72167.

Abstract

BACKGROUND

The global rise in the prevalence of diabetes significantly impacts the quality of life of both patients and their families. Despite advances in diabetes care, numerous challenges remain in its management. In recent years, digital tools have been increasingly integrated into diabetes care, demonstrating some positive outcomes. However, the long-term effectiveness and associated challenges of these tools in diabetes management remain areas for future research.

OBJECTIVE

This study aims to assess the types and current usage of digital tools in diabetes management, analyze their benefits and limitations, and provide recommendations for optimizing their future application in diabetes care.

METHODS

This scoping review followed the 5-stage framework proposed by Arksey and O'Malley. A comprehensive literature search was conducted across 9 electronic databases (CNKI, Wanfang Database, VIP, Sinomed, PubMed, Embase, Web of Science, CINAHL, and Cochrane Library) from their inception to July 31, 2024. Study selection was independently performed by 2 reviewers, descriptive analysis was conducted, and findings were presented narratively, key study characteristics-including first author, publication date, country or region, study type, sample size, type of digital tools, intervention methods, intervention duration, limitations, and outcome indicators-were independently extracted and cross-checked by 2 investigators.

RESULTS

A total of 6263 articles were initially retrieved. After deduplication and a 2-stage screening process (initial screening based on titles and abstracts followed by full-text assessment), 45 studies meeting the predefined inclusion criteria were ultimately included for analysis, originating from 7 countries. The included studies demonstrated marked heterogeneity in research designs: randomized controlled trials (RCTs; n=26, 57.8%), non-RCTs (n=15, 33.3%), quasi-RCTs (n=1, 2.2%), observational studies (n=1, 2.2%), mixed-methods studies (n=1, 2.2%), and qualitative studies (n=1, 2.2%). The digital tools primarily included mobile health apps, integrated management information platforms, Diabetes Online Community (DOC), specialized monitoring and analytics tools, blood glucose information management systems, and remote monitoring and follow-up systems, among others. These tools were applied across home, hospital, and community settings. Outcome measures were primarily focused on evaluating glycemic control efficacy (eg, fasting blood glucose, postprandial blood glucose, and glycated hemoglobin), blood lipid levels, BMI, self-management capacity, quality of life, patient satisfaction, and diabetes knowledge.

CONCLUSIONS

This review highlights the diversity and potential value of digital tools in diabetes care, particularly in supporting patient self-management and extending care across multiple settings. From a nursing perspective, digital interventions offer opportunities for individualized care, patient engagement, and continuity of services. However, challenges such as technology acceptance remain. Future studies should address gaps related to long-term effectiveness, economic evaluation, and tool adaptation for aging populations, while incorporating interdisciplinary approaches and real-world evidence to inform sustainable digital health strategies.

摘要

背景

全球糖尿病患病率的上升对患者及其家庭的生活质量产生了重大影响。尽管糖尿病护理取得了进展,但其管理仍面临诸多挑战。近年来,数字工具越来越多地融入糖尿病护理中,并显示出一些积极成果。然而,这些工具在糖尿病管理中的长期有效性及相关挑战仍是未来研究的领域。

目的

本研究旨在评估糖尿病管理中数字工具的类型和当前使用情况,分析其益处和局限性,并为优化其在糖尿病护理中的未来应用提供建议。

方法

本范围综述遵循了Arksey和O'Malley提出的5阶段框架。对9个电子数据库(中国知网、万方数据库、维普资讯、中国生物医学文献数据库、PubMed、Embase、Web of Science、CINAHL和Cochrane图书馆)从建库至2024年7月31日进行了全面的文献检索。由2名评审员独立进行研究选择,进行描述性分析,并以叙述方式呈现研究结果。关键研究特征,包括第一作者、发表日期、国家或地区、研究类型、样本量、数字工具类型、干预方法、干预持续时间、局限性和结果指标,由2名研究人员独立提取并交叉核对。

结果

最初检索到6263篇文章。经过去重和两阶段筛选过程(基于标题和摘要的初步筛选,随后进行全文评估),最终纳入45项符合预定义纳入标准的研究进行分析,这些研究来自7个国家。纳入的研究在研究设计上表现出明显的异质性:随机对照试验(RCTs;n = 26,57.8%)、非RCTs(n = 15,33.3%)、准RCTs(n = 1,2.2%)、观察性研究(n = 1,2.2%)、混合方法研究(n = 1,2.2%)和定性研究(n = 1,2.2%)。数字工具主要包括移动健康应用程序、综合管理信息平台、糖尿病在线社区(DOC)、专业监测和分析工具、血糖信息管理系统以及远程监测和随访系统等。这些工具应用于家庭、医院和社区环境。结果测量主要集中在评估血糖控制效果(如空腹血糖、餐后血糖和糖化血红蛋白)、血脂水平、BMI、自我管理能力、生活质量、患者满意度和糖尿病知识。

结论

本综述强调了数字工具在糖尿病护理中的多样性和潜在价值,特别是在支持患者自我管理和跨多种环境扩展护理方面。从护理角度来看,数字干预为个性化护理、患者参与和服务连续性提供了机会。然而,技术接受等挑战仍然存在。未来的研究应解决与长期有效性、经济评估以及针对老年人群的工具适应性相关的差距,同时纳入跨学科方法和真实世界证据,以为可持续的数字健康战略提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8a4/12364422/2136496271d4/jmir-v27-e72167-g001.jpg

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