动机性访谈对慢性心力衰竭患者疾病管理影响的Meta分析

Influence of motivated interviews in improving the ability of disease management of patients with 1 chronic heart failure: a Meta analysis

目的评价动机性访谈对慢性心力衰竭患者疾病管理的影响。方法检索Web of Science、Pub Med、High Wire、MEDLINE、中国学术期刊数据库、万方数据知识服务平台及中国生物医学文献服务系统这七个中英文医学文献数据库中关于动机性访谈应用于慢性心力衰竭患者的相关临床随机对照试验。对纳入研究利用Rev Man 5.3进行Meta分析研究。结果共纳入研究6篇,皆是随机对照试验研究。Meta分析结果表明,在动机性访谈与传统健康教育之间,服药依从性(RR:1.37,95%CI:1.15,1.63,P=0.000 4)、饮食管理(SMD:1.45,95%CI:1.20,170,P=0.000 4)、药物管理(SMD:1.57,95%CI:0.70,2.44,P<0.000 01)、心理及社会适应(SMD:1.99,95%CI:1.50,2.49,P<0.000 01)、症状管理(SMD:1.99,95%CI:1.10,2.88,P<0.000 1)、再次入院率(RR:0.56,95%CI:0.38,0.81,P=0.003)的差异均有统计学意义。结论动机性访谈可以提高慢性心力衰竭患者服药依从性及自我管理能力,改掉不良的生活习惯,减少3个月内再入院率。

Objective To evaluate the influence of motivated interviews in improving the ability of disease management of patients with chronic heart failure. Methods Searched clinical randomized controlled trials about motivational interviewing used in the patients with chronic heart failure in the Web of Science, Pub Med, High Wire, MEDLINE, CNKI, Wanfang data knowledge service platform and CBM. The Meta-analysis was performed by using Review Manager(Version 5.3). Results The six studies all were randomized controlled. Meta-analysis results showed that the differences were statistically significant between the traditional health education and motivational interviewing about medication adherence(RR 1.37, 95% CI: 1.15, 1.63, P=0.000 4), dietary management(SMD: 1.45, 95% CI: 1.20, 170, P=0.000 4), drug management(SMD: 1.57, 95% CI: 0.70, 2.44, P<0.000 01), psychological and social adaptation(SMD: 1.99, 95% CI: 1.50, 2.49, P<0.000 01), symptom management(SMD: 1.99, 95% CI: 1.10, 2.88, P<0.000 1), readmission rate(RR 0.56, 95% CI: 0.38, 0.81, P=0.003). Conclusion Motivational interviewing can improve the medication compliance and self-management ability of patients with chronic heart failure, get rid of bad habits and reduce the rate of readmission within three months.