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基于叙事的干预措施对慢性疾病的自我有效性和自我管理的影响:系统性审查和元分析
Zhuangyan Yao1,2, Edmond Pui Hang Choi2, Do Do Wai Nei Chow2
1Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.
Applied psychology. Health and well-being
|February 18, 2026
概括
叙事干预显著改善慢性疾病患者的自我有效性和自我管理行为. 这些发现突出了讲故事在提高患者的治疗结果和治疗计划的遵守方面的潜力.
科学领域:
- 健康科学 卫生科学 卫生科学
- 心理学 心理学 心理学
- 公共卫生 公共卫生
背景情况:
- 慢性疾病对全球健康造成重大负担,需要有效的患者支持策略.
- 自我有效性和自我管理行为对于管理慢性疾病和改善患者结果至关重要.
- 目前的干预措施可能无法完全解决慢性疾病管理的心理和行为方面的问题.
研究的目的:
- 系统地审查和元分析叙事干预对慢性疾病成年人自我有效性和自我管理行为的影响.
- 综合随机对照试验 (RCT) 的证据,以量化基于叙事方法的有效性.
- 探索潜在的调节因素,影响叙事干预的有效性.
主要方法:
- 在多个数据库 (EMBASE,Cochrane图书馆,CINAHL,PsycINFO,CNKI,PubMed) 进行系统的文献搜索,直到2025年.
- 包括随机对照试验 (RCT),涉及成年慢性病患者接受叙述干预.
- 随机效应元分析和元回归,以汇集数据并评估异质性和缓和效应.
主要成果:
- 在患有慢性疾病的患者中,叙述性干预显著提高了自我效能 (SMD = 0.66) 和自我管理行为 (SMD = 1.73).
- 亚组分析表明,在高收入至中等收入国家和特定疾病群体 (心脏病,癌症,中风) 中,自我有效性得到了更大的改善.
- 在患有神经疾病和癌症的患者中观察到对自我管理的显著影响,因干预类型,持续时间和出版期而异.
结论:
- 基于叙述的干预措施在改善慢性疾病患者的自我有效性和自我管理行为方面表现有前途.
- 叙事干预的有效性可能会受到国家收入水平和特定疾病特征等因素的影响.
- 鉴于观察到的异质性,需要进一步进行高质量的研究来证实这些发现,并探索最佳的实施策略.
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