Mazzuca S A
J Chronic Dis. 1982;35(7):521-9. doi: 10.1016/0021-9681(82)90071-6.
A pool of 320 articles on patient education were screened to select controlled experiments in chronic disease where the dependent variables included (a) compliance with therapeutic regimen, (b) physiological progress of patients or (c) long-range outcome. Thirty such articles were found; and the magnitude of experimental effects of patient education were calculated using an empirical form of integrating research findings known as meta-analysis. Summary of all experimental effects showed patient education most successful in altering compliance (average improvement = 0.67 sigma over control, p less than 0.05). However, average improvements in physiological progress (0.49 sigma) and health outcome (0.02 sigma) were also statistically significant (p less than 0.01 and p less than 0.05, respectively). Efforts to improve health by increasing patient knowledge alone were rarely successful. Behaviorally-oriented program, often with special attention to changing the environment in which patients care for themselves, were consistently more successful at improving the clinical course of chronic disease.
对320篇关于患者教育的文章进行筛选,以选取慢性病方面的对照实验,这些实验的因变量包括:(a)对治疗方案的依从性;(b)患者的生理进展;或(c)长期结果。共找到30篇此类文章;并使用一种称为荟萃分析的实证形式来整合研究结果,计算患者教育的实验效应大小。所有实验效应的总结表明,患者教育在改变依从性方面最为成功(平均改善程度 = 比对照组高出0.67个标准差,p < 0.05)。然而,生理进展(0.49个标准差)和健康结果(0.02个标准差)的平均改善在统计学上也具有显著意义(分别为p < 0.01和p < 0.05)。仅通过增加患者知识来改善健康的努力很少成功。以行为为导向的项目,通常特别关注改变患者自我护理的环境,在改善慢性病临床进程方面一直更成功。