高血压患者群组干预管理模式的效果Meta分析

摘要

目的 评价群组干预管理模式在高血压患者管理中的实施效果.方法 计算机检索Cochrane Library、JBI Library、PubMed、Ovid、Springer、Web of Science、Medline、中国期刊全文数据库、中国生物医学文献服务系统、万方、维普数据库,搜集对成年高血压患者进行群组干预管理的随机对照试验,数据库检索时限均为建库至2016年4月15日.由2名研究员按照纳入和排除标准筛选文献、提取资料和质量评价后,采用RevMan 5.3进行Meta分析.结果 最终纳入12篇文献,Meta分析结果显示:群组干预管理组高血压患者收缩压改善优于常规护理组(MD=-4.12,95%CI:-5.49~-2.74,P<0.01),舒张压改善优于常规护理组(MD=-1.79,95%CI:-2.18~-1.39,P<0.01).群组干预管理组高血压患者服药依从性高于常规护理组(OR=1.32,95%CI:1.04~1.67,P=0.02).群组干预管理组高血压患者锻炼自我效能优于常规护理组(MD=0.41,95%CI:0.16~0.67,P<0.01),症状管理自我效能优于常规护理组(MD=0.59,95%CI:0.19~0.98,P<0.01),疾病管理自我效能优于常规护理组(MD=0.52,95%CI:0.40~0.65,P<0.01).结论 群组干预管理模式能改善高血压患者的血压水平,提高患者的服药依从性及自我效能.%Objective To review the effectiveness of group intervention in patients with hypertension. Methods We searched the Cochrane Library, The Joanna Briggs Institute Library, PubMed, Ovid, Springer, Web of Science, Medline, CNKI, CBM, Wanfang and VIP database to collect randomized controlled trials (RCTs) regarding group intervention in adult patients with hypertension. Retrieval time for literatures was from the establishment of the database to April 15th 2016. Two researchers worked independently to select the literature and make quality assessment, then Meta analysis was conducted with RevMan 5.3. Results 12 studies were included.The results of meta-analysis were shown below.There were obvious improvement of the average decrease of systolic blood pressure and diastolic blood pressure in the group intervention groups when compared with that in the control groups ( MD=-4.12, 95%CI:-5.49~-2.74,P<0.01;MD=-1.79, 95%CI:-2.18~-1.39, P<0.01).There were better medication compliance in the group intervention groups than that in the control groups (OR=1.32,95%CI:1.04~1.67,P=0.02). Self-efficacy of physical activity,managing symptom and managing disease in the group intervention groups were significantly better than those in the control groups ( MD=0.41,95%CI:0.16~0.67,P<0.01;MD=0.59, 95%CI:0.19~0.98,P<0.01; MD=0.52, 95%CI:0.40~0.65, P<0.01). Conclusion Group intervention can significantly decrease blood pressure, improve the medication compliance and self-efficacy in patients with hypertension.