背景:远程指导已被护士用作2型糖尿病患者可获得和可持续的干预措施之一。然而,一直缺乏证据证明其在缓解相关心血管危险因素方面的有效性.
目的:系统评估护士主导的远程辅导对可改变的心血管危险因素(糖化血红蛋白,血压,和血脂水平)在2型糖尿病患者中。
方法:对八个数据库的系统搜索(CochraneLibrary,PubMed,Embase,护理和相关健康文献的累积指数,Scopus,PsycINFO,WebofScience,&ProQuest论文和论文)进行了以护士为主导的针对2型糖尿病患者的远程指导的随机对照试验,截至2018年10月30日以英文发表。对研究的主要结果进行了荟萃分析。
结果:选择了12项随机对照试验,包括3,030名参与者。荟萃分析结果显示,不仅糖化血红蛋白的降低具有统计学意义(合并平均差=-1.23,95%CI:-1.63至-0.8,I2=0%,p<.00),还包括收缩压(SBP;合并平均差=-2.22,95%CI:-3.95至-0.49,I2=0%,p<.01);这些发现支持在主要结果上使用护士主导的远程教练。
■荟萃分析的结果表明,护士主导的远程辅导是一种有效且可获得的干预措施,可以改善2型糖尿病患者的血糖控制和SBP。
BACKGROUND: Tele-coaching has been used by nurses as one of the accessible and sustainable interventions for individuals with type 2 diabetes mellitus. However, evidence has been lacking to demonstrate its effectiveness in mitigating the related cardiovascular risk factors.
OBJECTIVE: To systematically evaluate the effectiveness of nurse-led tele-coaching on the modifiable cardiovascular risk factors (glycated hemoglobin, blood pressure, & lipid levels) among individuals with type 2 diabetes mellitus.
METHODS: A systematic search of eight databases (Cochrane Library, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Scopus, PsycINFO, Web of Science, & ProQuest Dissertations and Theses) was conducted for randomized controlled trials of nurse-led tele-coaching for individuals with type 2 diabetes mellitus published in English up to October 30, 2018. A meta-analysis was conducted for the primary outcomes of the studies.
RESULTS: Twelve randomized controlled trials were selected that included 3,030 participants. Results from the meta-analysis revealed statistically significant reductions for not only glycated hemoglobin (pooled mean difference = -1.23, 95% CI: -1.63 to -0.8, I2 = 0%, p < .00) but also systolic blood pressure (SBP; pooled mean difference = -2.22, 95% CI: -3.95 to -0.49, I2 = 0%, p < .01); such findings are supportive of the use of nurse-led tele-coaching on the primary outcome.
UNASSIGNED: Results from the meta-analyses have shown that nurse-led tele-coaching is an effective and accessible intervention that could improve the glycemic control and SBP among individuals with type 2 diabetes mellitus.