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冠心病同行支持干预措施的有效性:系统性审查和元分析
Joseph Weddell1,2, Wendan Shi1,2, Julie Redfern1,3
1Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
对冠心病 (CHD) 患者的同行支持干预显著改善了自我管理行为,并减少了再入院. 虽然这些干预措施不会影响焦虑或抑郁,但会提高自我效能,为患者的康复提供有价值的工具.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 行为科学 行为科学
背景情况:
- 冠心病 (CHD) 对患者的心理社会福祉和自我管理构成重大挑战.
- 越来越多地探索同行支持干预作为一种改善慢性疾病管理结果的策略.
研究的目的:
- 评估同行支持干预措施对心理社会结果,自我管理行为和患有心血管疾病的个人的医院再入院的影响.
- 描述所采用的各种同行支持策略,包括它们的启动,交付方法,强度,时间,内容以及同行支持者的特点/培训.
主要方法:
- 根据PRISMA指南,对16项随机对照试验 (n=2013) 进行了系统审查和元分析.
- 数据使用元分析来合成可量化的结果和叙事合成用于定性方面.
- 在多个数据库中进行了搜索,包括MEDLINE,Embase,PsycINFO,CINAHL,Scopus,PubMed,Web of Science和Cochrane中央注册.
主要成果:
- 同龄人支持并没有显著影响焦虑,抑郁,与健康相关的生活质量或感知到的社会支持.
- 在自我管理行为 (SMD 1.49) 和长达6个月的自我有效性 (SMD 0.57),在6-12个月的持续自我有效性 (SMD 0.67) 中观察到显著的改善.
- 报道指出,重新接收人数显著减少 (RR 0.25). 共同的策略包括面对面的支持 (56%) 和以小组为基础的经验分享 (44%).
结论:
- 同行支持干预措施有望提高自我管理和自我有效性,并降低心血管疾病患者的再入院率.
- 面对面和以小组为基础的策略,特别是那些在入院期间启动的策略,似乎最有效.
- 进一步的研究可能会完善为不同患者群体提供最佳的同行支持.
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