永久性结肠造口患者同伴教育效果的meta分析
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摘要
目的系统评价同伴教育在永久性结肠造口患者中的应用效果。方法计算机检索The Cochrane Library、PubMed、EMbase、Web of Science、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、维普中文期刊数据库(VIP)、万方数据库中关于同伴教育对永久性结肠造口患者干预效果的随机对照试验和半随机对照试验,并采用RevMan 5.3软件进行数据分析。结果共纳入8篇文献,合计664例患者。Meta分析结果显示,同伴教育干预措施较常规干预提高了永久性结肠造口患者的自护能力,合并效应有统计学意义(MD=16.96,95%CI:4.83～29.09,P<0.05);提高了患者的社会心理适应水平,合并效应有统计学意义(MD=13.34,95%CI:5.80～20.87,P<0.05);改善了患者的焦虑症状,合并效应有统计学意义(SMD=-0.61,95%CI:-0.86～-0.35,P<0.01)。结论同伴教育能够提高永久性结肠造口患者的自护能力、社会心理适应水平和改善患者焦虑症状。
[Objective]To systematically review the effect of peer education intervention in patients with permanent colostomy.[Methods]Randomized controlled trial(RCT) and controlled clinical trial(CCT) regarding the effect of peer education intervention in patients with permanent colostomy were retrieved in electronic databases such as Cochrane Library,Pub Med,EMbase,Web of Science,CBM,CNKI,VIP and Wanfang data and then RevMan5.3 software was used to analyze the data.[Results]Eight studies involving 664 patients were included. The results of meta-analysis supported the effectiveness of peer education on improving selfcare ability in patients with permanent colostomy[MD=16.96,95%CI=(4.83-29.09),P<0.05],as well as the effectiveness on improving psychosocial adaptation [ MD = 13. 34, 95 % C I =(5.80-20.87),P <0.05],and alleviating anxiety symptoms [SMD =-0.61,95% CI(-0.86--0.35),P<0.01]. [Conclusion]The peer education could improve the self-care ability and psychosocial adaptation,alleviate anxiety symptoms of patients with permanent colostomy.
[Objective]To systematically review the effect of peer education intervention in patients with permanent colostomy.[Methods]Randomized controlled trial(RCT) and controlled clinical trial(CCT) regarding the effect of peer education intervention in patients with permanent colostomy were retrieved in electronic databases such as Cochrane Library,Pub Med,EMbase,Web of Science,CBM,CNKI,VIP and Wanfang data and then RevMan5.3 software was used to analyze the data.[Results]Eight studies involving 664 patients were included. The results of meta-analysis supported the effectiveness of peer education on improving selfcare ability in patients with permanent colostomy[MD=16.96,95%CI=(4.83-29.09),P<0.05],as well as the effectiveness on improving psychosocial adaptation [ MD = 13. 34, 95 % C I =(5.80-20.87),P <0.05],and alleviating anxiety symptoms [SMD =-0.61,95% CI(-0.86--0.35),P<0.01]. [Conclusion]The peer education could improve the self-care ability and psychosocial adaptation,alleviate anxiety symptoms of patients with permanent colostomy.
引文
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[28]王妃凤,梁桂花,徐飞鹏,等.永久性结肠造口患者社会心理适应能力的影响因素及护理对策[J].临床医学工程,2017,24(10):1443-1444.
[29]龚芸,张丽,冯泽会,等.同伴教育对131I治疗分化型甲状腺癌患者焦虑及抑郁症状的影响[J].湖北医药学院学报,2015,34(2):192-194.
[30]何英,李芝云.同伴支持干预在肿瘤患者中的应用[J].齐鲁护理杂志,2018,24(4):18-19.
[31]史莉娜,马玉芬,王光健.同伴教育对永久性结肠造口患者生活质量及社会心理适应状况的影响[J].解放军护理杂志,2017,34(24):66-71.
[2]陈万青,李贺,孙可欣,等.2014年中国恶性肿瘤发病和死亡分析[J].中华肿瘤杂志,2018,40(1):5-13.
[3]中华医学会消化内镜学分会.中国早期结直肠癌筛查及内镜诊治指南(2014年,北京)[J].中华消化内镜杂志,2015,32(6):341-360.
[4]姜华.直肠癌永久性结肠造口术后患者的临床护理[J].齐鲁护理杂志,2018,24(4):78-80.
[5]CHERRINGTON A,MARTIN MY,HAYES M,et al.Intervention mapping as a guide for the development of a diabetes peer support intervention in rural Alabama[J].Prev Chronic Dis,2012,9(4):1-10.
[6]COCKLE-HEARNE J,COOKE D,FAITHFULL S.Developing peer support in film for cancer self-management:what do men want other men to know?[J].Support Care Cancer,2016,24(4):1625-1631.
[7]BOOTHROYD RI,FISHER EB.Peers for progress:promoting peer support for health around the world[J].Fam Pract,2010,27(3):162-168.
[8]唐茂婷,刘贤亮,施雁.同伴教育在结直肠癌造口患者中的实施现状综述[J].中华护理杂志,2016,51(10):1217-1220.
[9]王明虹,于德华,张斌,等.同伴支持在恶性肿瘤领域的研究进展[J].中华全科医学,2016,14(9):1550-1552.
[10]WANG HH,LAFFREY SC.Preliminary development and testing of instruments to measure self-care agency and social support of women in Taiwan[J].Kaohsiung J Med Sci,2000,16(9):459-467.
[11]许勤,程芳,戴晓冬.中文版造口者社会心理适应量表的修订及信效度评价[J].江苏医药,2010,36(14):1647-1649.
[12]中华医学会精神科分会.CCMD-3中国精神障碍分类与诊断标准[M].济南:山东科学技术出版社,2001:106-107.
[13]CHAGAS MH,TUMAS V,LOUREIRO SR,et al.Validity of a Brazilian version of the Zung self-rating depression scale for screening of depression in patients with Parkinson's disease[J].Parkinsonism Relat Disord,2010,16(1):42-45.
[14]HIGGINS J,GREEN S.Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[M].Wiley-Blackwell,2011:102-108.
[15]胡雁.循证护理学[M].北京:人民卫生出版社,2012:73-76.
[16]朱珍玲,谢伶俐.同伴教育对永久性结肠造口患者自我护理能力和适应水平的影响[J].当代护士(下旬刊),2016(5):140-142.
[17]朱文娟,吴爱玲,杨群英.同伴支持小组协同护理模式对肠造口患者自我护理和适应水平的影响[J].护理学杂志,2015,30(4):5-8.
[18]徐莺,翟巧玲.同伴教育对围手术期结肠造口患者自我护理能力的影响[J].吉林医学,2013,34(32):6866-6868.
[19]金莉.同伴教育在围手术期结肠造口患者心理护理中的应用研究[J].大连大学学报,2014,35(6):101-103.
[20]程芳,孟爱凤,羊丽芳,等.同伴教育对永久性结肠造口患者术后早期社会心理适应的影响[J].中华护理杂志,2013,48(2):106-108.
[21]柳冉冉,刘东英.同伴支持在永久性结肠造口患者自我管理中的应用研究[J].世界最新医学信息文摘,2017,17(26):210-211.
[22]刘玉莹,耿云平,房芳,等.同伴支持教育对直肠癌造口患者术后延续护理效果的影响[J].世界华人消化杂志,2015,23(20):3321-3325.
[23]任洁娜,李鲜.造口治疗师联合造口志愿者对肠造口患者实施心理干预[J].护理实践与研究,2013,10(20):105-107.
[24]包立立,周晶晶,王英,等.个性化延续健康教育在永久性结肠造口患者中的应用[J].齐鲁护理杂志,2017,23(22):18-20.
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[27]何松雪,刘国杰,刘虹泽,等.永久性结肠造口患者伤残接受度与社会支持及应对方式的相关性分析[J].护理学报,2015,22(13):24-26.
[28]王妃凤,梁桂花,徐飞鹏,等.永久性结肠造口患者社会心理适应能力的影响因素及护理对策[J].临床医学工程,2017,24(10):1443-1444.
[29]龚芸,张丽,冯泽会,等.同伴教育对131I治疗分化型甲状腺癌患者焦虑及抑郁症状的影响[J].湖北医药学院学报,2015,34(2):192-194.
[30]何英,李芝云.同伴支持干预在肿瘤患者中的应用[J].齐鲁护理杂志,2018,24(4):18-19.
[31]史莉娜,马玉芬,王光健.同伴教育对永久性结肠造口患者生活质量及社会心理适应状况的影响[J].解放军护理杂志,2017,34(24):66-71.