2型糖尿病患者自助干预的证据图谱

Evidence Mapping for Self-help Interventions in Patients with Type 2 Diabetes Mellitus

目的通过证据图谱方法系统描述和评价2型糖尿病患者自助干预的相关研究,为今后开展自助干预研究提供指导。方法计算机检索建库至2022年11月中国知网、万方数据、维普、中国生物医学数据库、PubMed、Cochrane Library、Web of Science、EMBASE,获取2型糖尿病患者自助干预的随机对照试验和系统评价/Meta分析。采用Risk of Bias和AMSTAR-2对纳入的研究进行质量评价,基于《护理结局分类》对结局指标进行分类,利用Excel对纳入的研究进行数据提取与编码,采用气泡图综合呈现纳入的研究内容。结果最终纳入43篇文献,包括41篇随机对照试验和2篇系统评价/Meta分析,共涉及3种干预类型和10种自助干预方法。包括自我管理干预3篇(7%),单纯自助20篇(47%),引导自助20篇(47%);干预方法主要是自助手册、互联网平台、专用管理软件等,结局指标主要包括血糖水平34篇(79%)、自我管理能力14篇(33%)、生活质量9篇(21%)等;有18篇(42%)结局效果为有益,24篇(56%)为可能有益。另外,干预时间主要在6个月之内,研究场所集中于医院和社区。结论自助干预对2型糖尿病患者是有效、易实施的,具有推广性。但不同干预类型、方法和途径,干预效果是存在差异性的。未来可以利用数据驱动、机器人来构建自助干预方法并重视干预效果的持久性。

Objective To systematically describe and evaluate self-help intervention in patients with type 2 diabetes mellitus,to provide guidance for future self-help intervention research through evidence mapping method.Methods Related studies on self-help intervention for patients with type 2 diabetes mellitus were searched in CNKI,Wanfang Data,VIP,CBM,PubMed,Cochrane Library,Web of Science,and EMBASE from inception to November 2022.The quality of the studies was assessed using the risk of bias(RoB)tool and A Measurement Tool to Assess Systematic Review-2(AMSTAR-2).Based on the Nursing Outcome Classification,the outcome indexes were classified.An evidence mapping framework was established,using Microsoft Excel tools for data extraction and coding,and using bubble charts to comprehensively present the research content.Results A total of 41 randomized controlled trials and 2 systematic reviews/Meta-analyses were included,which involved three intervention types with 10 self-help intervention methods.Including self-administered(3,7%),pure self-help(20,47%),and guided self-help(20,47%).The main intervention methods included a self-service manual,internet platform,dedicated management software,etc.The main outcome indicators included blood glucose level(34,79%),self-management ability(14,33%),and quality of life(9,21%).18(42%)of the research conclusions were classified as"beneficial",24(56%)of the research conclusions were classified"probably beneficial".In addition,the intervention duration was mainly within 6 months,and the study sites were concentrated in hospitals and communities.Conclusion Self-help intervention may be effective for patients with type 2 diabetes mellitus.At the same time,it is easy to implement and promote.However,its effectiveness are different for different types、methods and approaches of interventions.In the further study,we can use data-driven and robotics to build selfhelp interventions,and we also need to focus on the durability of the intervention's effects.