动机性访谈对原发性高血压患者运动改变阶段及生活质量影响的Meta分析

Effects of motivational interview on behavior change stages and quality of life in patients with hypertension: a systemic review and Meta-analysis

目的系统分析动机性访谈对原发性高血压患者运动改变阶段及生活质量临床效果。方法计算机检索2018年6月前在Pubmed、Embase、CochraneLibrary、Web of Science、CNKI、万方数据库、维普数据库和中国生物医学文献数据库(CBM)等已经公开发表的关于动机性访谈干预对原发性高血压患者生活质量或运动改变阶段影响的相关文献。应用均数差(MDs)作为两组生活质量评分的合并效应量。应用相对危险度(RR)作为运动改变阶段的合并效应量。通过Cochrane协作网提供的RevMan5.3统计软件进行Meta分析。结果9项随机对照试验共1238例研究对象(动机性访谈组618例,对照组620例)。动机性访谈干预后3个月和6个月时,动机性访谈组的原发性高血压患者生活质量测定量表评分均高于对照组(MD=6.21,95%CI:2.48~9.94,P=0.001;MD=6.49,95%CI:5.53~7.44,P<0.001),并且动机性访谈组患者原发性高血压患者生活质量测定量表各维度也均高于对照组,差异有统计学意义(P<0.05)。干预后3、6个月,除准备阶段外,动机性访谈组患者较对照组患者,运动阶段改变积极性均有所提高,差异有统计学意义(P<0.05)。结论动机性访谈可以有效提高原发性高血压患者运动积极性,同时有效改善其生活质量,值得临床推广。

Objective To evaluate effects of motivational interviewing on behavior change stages and quality of life in patients with hypertension. Methods The published literature on the effects of motivational interviewing on behavior change stages and quality of life in patients with hypertension before June 2018 was retrieved by computer from the databases of Pubmed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data and China Biological Medicine(CBM)databases. Mean difference( MDs) was used as the combined effect of quality of life scores in the two groups. Relative risk( RR) was used as a combined effect in the stage of behavior change. Meta-analysis was carried out through RevMan 5.3 statistical software provided by Cochrane Collaboration Network. Results A total of 9 RCTs involving 1 238 cases( motivational interviewing group 618, control group 620) met the inclusion criteria. At the 3rd month and 6th month after motivational interview, the scores of quality of life measurement scale for patients with hypertension in the motivational interviewing group were higher than those in the control group( MD=6.21, 95%CI: 2.48-9.94, P=0.001;MD=6.49, 95%CI: 5.53- 7.44, P < 0.001). The scores of dimensions of quality of life measurement scale in patients with hypertension in the motivational interviewing group were higher than those in the control group( P<0.05). At the 3rd month and 6th month after motivational interview, besides the preparation stage, the motivation interview group showed a higher change of motivation than the control group( P<0.05). Conclusions Motivational interviews can effectively improve the motivation of patients with essential hypertension and their quality of life, which is worthy of clinical promotion.