动机性访谈对高血压患者干预效果的Meta分析

A Meta-analysis of the Effect of Motivational Interviewing on Hypertension

目的系统评价动机性访谈对高血压患者的干预效果,为临床干预提供依据。方法检索万方数据库、中国知网数据库(CNKI)、维普期刊数据库(VIP)、中国生物医学文献数据库(CBM)、Cochrane Library、PubMed、Embase及Web of Science数据库,收集动机性访谈对高血压患者干预的随机对照研究,检索时间为数据库建库至2019年6月。采用RevMan 5.3软件进行Meta分析。结果共检索出1 176篇文献,经查重、阅读摘要、阅读全文后,最终纳入13篇文献,文献质量等级均为B。纳入研究的观察组动机性访谈时间为1~18个月。Meta分析显示,动机性访谈可降低高血压患者的收缩压[MD=-2.56,95%CI为(-3.57,-1.55), P<0.000 01]和舒张压[MD=-0.89,95%CI为(-1.51,-0.27),P=0.005],提高高血压患者的自我效能[MD=2.52, 95%CI为(1.56, 3.47), P<0.000 01]、生活质量[MD=6.99,95%CI为(3.25,10.74),P=0.000 3]、服药依从性[OR=4.30, 95%CI为(1.53, 12.10),P=0.006]。结论动机性访谈能够降低高血压患者的血压,并提高患者的自我效能、生活质量及服药依从性。

Objective To systematically evaluate the effect of motivational interviewing on hypertensive patients,providing a basis for clinical intervention.Methods Randomized controlled studies on the intervention of motivational interviewing in hypertensive patients were retrieved in Wanfang Data,China National Knowledge Infrastructure(CNKI),VIP Database,CBM disc database,Cochrane Library,PubMed,Embase and Web of Science from database establishment to June 2019.RevMan 5.3 was used for the meta-analysis.Results A total of 1176 papers were retrieved,and 13 of them were finally included after duplicate checking and reading abstracts or full texts.The quality of the papers was Grade B.The duration of motivational interviewing in the observation groups included in the studies ranged from 1 to 18 months.The meta-analysis showed that motivational interviewing could reduce systolic pressure[MD=-2.56,95%CI(-3.57,-1.55),Ph 0.00001]and diastolic pressure[MD=-0.89,95%CI(-1.51,-0.27),P=0.005],and improve self-efficacy[MD=2.52,95%CI(1.56,3.47),P<0.00001],quality of life[MD=6.99,95%CI(3.25,10.74),P=0.0003]and medication compliance[OR=4.30,95%CI(1.53,12.10),P=0.006].Conclusion Motivational interviewing can reduce the blood pressure of patients with hypertension,and improve their self-efficacy,quality of life and medication compliance.