延续护理对糖尿病病人干预效果的系统评价

Systern evaluation on intervention effect of continuity of care for patients with diabetes mellitus

[目的]评价延续护理对糖尿病病人的干预效果。[方法]计算机检索Cochrane Library(2015年2期)、JBI Library(1980年—2015年)、PubMed(1966年—2015年)、中国知网(CNKI,1978年—2015年)、万方(1980年—2015年)、维普数据库(1989年—2015年)中关于延续护理对糖尿病病人干预效果的随机对照试验(RCT),由2名研究者对文献质量进行评价和提取资料,对符合治疗要求的文献进行Meta分析。[结果]共纳入26篇RCT,结果显示延续护理可以明显提高糖尿病病人的生活质量[生理功能WMD=5.51,95%CI(2.44,8.58),P<0.000 4,生理职能WMD=4.94,95%CI(1.53,8.34),P=0.004,躯体疼痛WMD=4.42,95%CI(0.39,8.46),P=0.03,一般状况WMD=6.46,95%CI(3.54,9.38),P<0.000 1,精力WMD=6.98,95%CI(4.59,9.37),P<0.000 01,社会功能WMD=6.19,95%CI(3.38,9.01),P<0.000 1,情感职能WMD=8.27,95%CI(5.92,10.63),P<0.000 01,精神健康WMD=7.28,95%CI(3.95,10.61),P<0.000 1],可以有效降低糖尿病病人的HbA1c值[WMD=-1.33,95%CI(-2.10,-0.56),P=0.000 7],延续护理组焦虑水平的改善优于常规护理组[WMD=1.22,95%CI(0.61,1.83),P<0.000 1],延续护理组自尊水平的提高优于常规护理组[WMD=5.90,95%CI(5.14,6.66),P<0.000 01],此外延续护理还可提高病人的依从性。[结论]对糖尿病病人实施延续护理,可以有效地控制血糖,提高病人的依从性和生活质量,对预防和减少并发症的发生具有重要意义。

Objective：To evaluate the intervention effect of continuity of care for patients with diabetes mellitus Methods：RCTs were searched in the Cochrane Library（2015）,JBI Library（1980-2015）PubMed（1966-2005）,CNKI（1978-2015）,Wanfang（1980-2015）,VIP database（1989-2015）on intervention effect of continuity of care for patients with diabetes mellitus：The quality of literature was evaluated and the data was extracted by 2researchers,Meta analysis was carried out for the literatures which met the treatment requirements.Results：A total of 26 articles were included in the RCT.The results showed that continuity of care could significantly improve the quality of life of diabetic patients.[Physiological function WMD=5.51,95%CI（2.44,8.58）,P〈0.000 4,physiological functions WMD=4.94,95%CI（1.53,8.34）,P=0.004,bodily pain WMD=4.42,95%CI（0.39,8.46）,P=0.03,general condition WMD=6.46,95%CI（3.54,9.38）,P〈0.000 1,energy WMD=6.98,95%CI（4.59,9.37）,P〈0.000 01,social function WMD=6.19,95%CI（3.38,9.01）,P〈0.000 1,emotional function WMD=8.27,95%CI（5.92,10.63）,P〈0.000 1mental health WMD=7.28,95%CI（3.95,10.61）,P〈0.000 1],could effectively reduce diabetes HbA1cvalues[WMD=-1.33,95%CI（-2.10,-0.56）,P〈0.000 7].In the continuity of care group,the improvement of anxiety level was better than that in routine nursing group[WMD=1.22,95%CI（0.61,1.83）,P〈0.000 1],improvement of self-esteem level was better than that in routine nursing group[WMD=5.90,95% CI（5.14,6.66）,P〈0.000 01]moreover continuity of care could improve patient＇s compliance.Conclusion：Continuity of care for patients with diabetes mellitus could effectively control blood glucose,improve patients＇ compliance and quality of life,and had important significance to prevent and reduce the occurrence of complications