對造口患者自我管理干預有效性的系統評價和薈萃分析

31401637060495548

Abstract

Aims

Explore the evidence from randomized controlled trials for the effect of self-management interventions on quality of life, self-management skills and self-efficacy, and to explore which intervention characteristics are associated with effectiveness.

Design

Systematic review.

Data sources

A search of the literature was conducted in these databases: MEDLINE (OVID), EMBASE (OVID) and PsychINFO (OVID) from January 2000 to February 2020.

Review methods

Studies were included if participants had a bowel stoma, were over the age of 18 and the design was a randomized controlled trial of a self-management programme. The outcome measures for this review were quality of life, self-management skills and self-efficacy. The Behaviour Change Technique Taxonomy was used to code interventions for underlying components and alongside other intervention characteristics, associations with improvements in outcomes were explored.

Results

The search identified 3141 articles, 16 of which were eligible. A meta-analysis of self-efficacy scores from five studies (N = 536) found an improvement in those that received the self-management intervention at follow-up with a 12-point mean difference compared with the usual care group. Effects on quality of life and self-management skills were mixed, and meta-analyses of these data were not possible. Across 13 studies an average of 10 behaviour change techniques were used with, credible source (e.g. nurse, doctor, therapist) (n = 13), instruction on how to perform the behaviour (n = 13), demonstration of the behaviour (n = 12) used most often. The behaviour change technique of self-monitoring was associated with an improvement in quality of life. The involvement of a nurse was associated with higher self-efficacy and self-management skills.

Conclusion

This review suggests that self-management interventions can increase peoples’ self-efficacy for managing their stoma.

Impact

A standardized approach to the reporting of interventions and the measures used is needed in future studies to better understand the effect on quality of life and self-management skills.

摘要翻譯（僅供參考）

宗旨

探索來自隨機對照試驗的關于自我管理干預對生活質量、自我管理技能和自我效能的影響的證據，并探索哪些干預特征與有效性相關。

設計

系統審查。

數據源

從 2000 年 1 月到 2020 年 2 月，在以下數據庫中檢索了文獻：MEDLINE (OVID)、EMBASE (OVID) 和 PsychINFO (OVID)。

復習方法

如果參與者有腸造口，年齡超過 18 歲，并且設計是一項自我管理計劃的隨機對照試驗，則研究被納入。本次審查的結果指標是生活質量、自我管理技能和自我效能。行為改變技術分類法用于對潛在組成部分的干預進行編碼，并與其他干預特征一起，探索與結果改善的關聯。

結果

搜索確定了 3141 篇文章，其中 16 篇符合條件。對來自五項研究 ( N = 536)的自我效能評分的薈萃分析發現，與常規護理組相比，接受自我管理干預的患者在隨訪中有 12 點的平均差異。對生活質量和自我管理技能的影響是混合的，無法對這些數據進行薈萃分析。在 13 項研究中，平均使用了 10 種行為改變技術，包括可靠來源（例如護士、醫生、治療師）（n = 13）、如何執行行為的指導（n = 13）、行為示范（n = 12) 最常用。自我監測的行為改變技術與生活質量的提高有關。護士的參與與更高的自我效能和自我管理技能有關。