Watt D, Verma S, Flynn L
Queen's University, Kingston, Ont.
CMAJ. 1998 Jan 27;158(2):224-30.
To review studies that have examined an association between wellness programs and improvements in quality of life and to assess the strength of the scientific evidence.
A MEDLINE search was constructed with the following medical subject headings: "psychoneuroimmunology," "chronic disease" and "health promotion," "chronic disease" and "health behaviour," "relaxation techniques," "music therapy," "laughter," "anger," "mediation" and "behavioural medicine." Searches using the text words "wellness" and "wellness program" were also carried out. References from the primary articles identified in the search and contemporary writing on wellness were also considered.
Selection was limited to randomized controlled trials or prospective studies published in English that involved human subjects and that took place between 1980 and 1996. All studies with an intervention aimed at promoting wellness and measuring outcomes were included, except studies of patients with cancer and HIV and studies of health promotion programs in the workplace. Of the 1082 references initially identified, 11 met the criteria for inclusion in the critical appraisal.
The following information was extracted from the 11 studies: characteristics of the study population, number of participants (and number followed to completion), length of follow-up, type of intervention, outcome measures and results. All 11 studies were assessed for the quality of their evidence.
All studies reported some positive outcomes following the intervention in question, although many had limitations precluding applicability of the results to a wider population.
Despite the suggested benefit associated with wellness programs, the evidence was inconclusive. Whether the composition of the target group or the type of intervention has a role in determining outcomes is unknown. Although trends suggest that wellness programs may be cost-effective, further research is needed for confirmation.
回顾研究健康促进计划与生活质量改善之间关联的研究，并评估科学证据的强度。
使用以下医学主题词构建了MEDLINE检索：“心理神经免疫学”、“慢性病”与“健康促进”、“慢性病”与“健康行为”、“放松技巧”、“音乐疗法”、“笑”、“愤怒”、“冥想”和“行为医学”。还使用了文本词“健康”和“健康促进计划”进行检索。检索中识别出的主要文章的参考文献以及关于健康的当代著作也被纳入考虑。
选择仅限于1980年至1996年间发表的、涉及人类受试者的英文随机对照试验或前瞻性研究。所有旨在促进健康并测量结果的干预研究均被纳入，但癌症和艾滋病患者的研究以及工作场所健康促进计划的研究除外。在最初识别出的1082篇参考文献中，有11篇符合纳入关键评估的标准。
从这11项研究中提取了以下信息：研究人群的特征、参与者数量（以及完成随访的数量）、随访时间长度、干预类型、结果测量指标和结果。对所有11项研究的证据质量进行了评估。
所有研究均报告了相关干预后的一些积极结果，尽管许多研究存在局限性，使得结果无法适用于更广泛的人群。
尽管健康促进计划有潜在益处，但证据尚无定论。目标群体的构成或干预类型是否在决定结果方面起作用尚不清楚。虽然趋势表明健康促进计划可能具有成本效益，但仍需进一步研究加以证实。
