血液透析患者授权教育效果的Meta分析

Meta-analysis of the effect of empowered education on hemodialysis patients

目的系统评价血液透析患者授权教育的干预效果。方法检索The Cochrane Library、PubMed、Ovid、Web of Science、EBSCO、中国生物医学文献数据库、中国知网、万方、维普和中国优秀硕博论文数据库等国内外数据库中关于授权教育对血液透析患者干预效果的随机对照研究。通过文献筛选、资料提取及质量评价后,采用Stata 12.0软件进行Meta分析。结果最终纳入13项随机对照研究,总计1 126例患者。Meta分析结果显示:授权教育组的白蛋白水平[SMD=0.59,95%CI(0.37,0.81),P<0.001]、饮食行为依从性[SMD=1.59,95%CI(1.35,1.84),P<0.001]、液体摄入依从性[OR=2.90,95%CI(1.53,5.51),P<0.001]和自我效能水平[SMD=1.00,95%CI(0.72,1.28),P<0.001]均高于常规组,差异均具有统计学意义;2组血红蛋白水平[SMD=0.21,95%CI(-0.02,0.45),P>0.05]、自我管理水平[SMD=0.68,95%CI(-0.19,1.54),P>0.05]、抑郁水平[SMD=-0.12,95%CI(-0.95,0.71),P>0.05]比较,差异均无统计学意义。结论授权教育可以有效改善血液透析患者的白蛋白水平、饮食行为依从性、液体摄入依从性及自我效能水平,但在改善血红蛋白水平、自我管理及抑郁情绪方面并无显著效果。

Objective To systematically evaluate the intervention effect of empowerment education on hemodialysis patients. Methods The Cochrane Library, PubMed, Ovid, Web of Science, EBSCO, Chinese biomedical literature database, China national knowledge infrastructure, Wan Fang, VIP and China excellent thesis and dissertation database were searched for the randomized controlled trial(RCT) about the effect of applying authorized education on hemodialysis patients. After literature screening, data extraction and quality evaluation, the Stata 12.0 software was used to conduct the meta-analysis. Results Thirteen randomized controlled trials involving 1 126 patients were included. The meta-analysis showed that the levels of albumin [SMD = 0.59, 95%CI(0.37, 0.81), P<0.001], dietary behavior compliance [SMD = 1.59, 95%CI(1.35, 1.84), P<0.001], liquid intake compliance [OR = 2.90, 95%CI(1.53, 5.51), P<0.001] and self-efficacy [SMD=1.00, 95%CI(0.72, 1.28), P<0.001] of the authorized education group were significantly higher than those of the conventional group. However, there were no significant differences between the two groups in the hemoglobin level [SMD=0.21, 95%CI(-0.02, 0.45), P>0.05], self-management level[SMD = 0.68,95%CI(-0.19,1.54),P>0.05]and depression level[SMD=-0.12,95%CI(-0.95,0.71),P>0.05].Conclusions Empowered education can effectively improve the albumin level,dietary behavior compliance,fluid intake compliance and self-efficacy of hemodialysis patients,but it has no significant effect on improving the hemoglobin level,self-management and depression.