久坐行为干预在慢性病患者中应用的范围综述

A scoping review of application of sedentary behavior interventions in patients with chronic diseases

目的对久坐行为干预在慢性病患者中的应用研究进行范围综述,识别久坐行为干预的传递载体、干预时间、干预内容以及干预结果,为卫生保健人员开展相关干预研究提供指导。方法系统检索PubMed、Embase、CINAHL、Cochrane Library、中国知网和万方数据库建库至2023年6月15日的文献,对纳入文献进行筛选、汇总和分析。结果共纳入25篇文献,其中久坐行为干预的传递载体包括线下指导、使用可穿戴设备监测、电话随访、手机移动应用程序、电子邮件、网站平台。干预的实施人员最常见的是康复治疗师,其次是护士、医生以及心理学家。干预时间为4周~3年。行为干预策略涵盖提供有关行为后果的信息、目标设定、行动计划、障碍识别/问题解决、行为反馈、探索社会支持、激励奖励、重组物理环境8个方面,干预的结局指标的类型包括久坐时间、身体活动时间、生理指标、心理指标、可行性评价以及安全性评价。干预结果显示,久坐行为干预不仅降低了慢性病患者的久坐行为,还会影响其生活质量、自我效能。结论久坐行为干预对慢性病患者久坐行为、身体活动、生理健康和心理健康均产生了积极影响。未来研究应加强手机移动应用程序的开发与应用,加强环境干预,以进一步提升干预效果。

Objective To conduct a scoping review on the application of sedentary behavior intervention in chronic disease patients and identify the delivery carriers,intervention time,intervention content and intervention results,so as to provide guidance for health care personnel to carry out relevant intervention research.Methods Literature was systematically searched in PubMed,Embase,CINAHL,Cochrane Library,China National Knowledge Infrastructure and Wanfang data from establishment of the databases to June 15,2023.The included literatures were screened,summarized and analyzed.Results A total of 25 articles were included,among which the delivery carriers of sedentary behavior intervention included offline guidance,wearable device monitoring,telephone follow-up,mobile phone applications,email and website platform.The most common intervention implementers were rehabilitation therapists,followed by nurses,doctors and psychologists.Intervention durations ranged from 4 weeks to 3 years.Behavioral intervention strategies covered eight aspects,including providing information about behavioral consequences,goal setting,action planning,obstacle identification/problem-solving,behavioral feedback,exploring social support,motivational rewards and restructuring the physical environment.The types of outcome indicators for intervention included sedentary time,physical activity time,physiological indicators,psychological indicators,feasibility evaluation and safety evaluation.The results showed that sedentary behavior intervention not only reduced sedentary behavior in patients with chronic diseases,but also affected their quality of life and self-efficacy.Conclusions Sedentary behavior intervention has positive effects on sedentary behavior,physical activity,physical health and mental health of patients with chronic diseases.Future research should strengthen the development and application of mobile phone applications and strengthen environmental intervention to further improve the intervention effect.