摘要
目的系统评价中国癫痫患者自我管理影响因素、干预措施和管理模式现状,为保障癫痫患者的治疗效果提供证据支撑。方法系统检索PubMed、EMBASE、Cochrane图书馆、CBM、CNKI、VIP和万方等国内外数据库,检索时间为建库至2023年3月,纳入针对中国癫痫患者的自我管理行为影响因素、干预措施和管理模式的文献。采用描述性方法对结果进行分析。结果共纳入21篇文献,其中影响因素文献2篇、干预措施研究14篇、管理模式5篇。20篇文献的研究对象为成人癫痫患者、1篇为13~17岁青少年癫痫,样本量为40~327例,中位样本量为70例。结果显示:自我管理行为与自我效能、本科及以上学历、女性和手术时长<3 h呈正相关,与30~50岁呈负相关。干预组的自我管理行为量表评分、服药依从性、治疗满意度、生活质量、癫痫发作频率、症状自评量表、焦虑、抑郁评分等指标优于对照组;自我管理模式干预后,干预组的自我管理得分、治疗有效率、生活质量和用药依从性等结局指标均优于对照组。结论中国癫痫患者自我管理水平不足,且影响因素和干预措施单一,缺乏基于个人、家庭、医疗系统和社会不同层面的整合干预措施和管理模式。建议循证构建癫痫患者自我管理模式,提升自我效能和自我管理水平。
Objective To systematically evaluate the influencing factors,intervention measures and management mode of epilepsy patients in China,so as to provide evidence support for ensuring the therapeutic effect of epilepsy patients.Methods PubMed,EMBASE,Cochrane Library,CBM,CNKI,VIP,Wanfang and other domestic and foreign databases were systematically searched,and the literature on influencing factors,intervention measures and management modes of self-management behavior of epilepsy patients in China was included.Descriptive methods were used to analyze the results.Results A total of 21 studies were included,including 2 studies on influencing factors,14 studies on intervention measures and 5 studies on management mode.The participants of 20 studies is adult epilepsy patients,and one study is adolescent epilepsy aged 13~17,with a sample size of 40~327 cases and a median sample size of 70 cases.The results showed that self-management behavior is positively correlated with self-efficacy,bachelor degree or above,female and operation duration<3 hours,and negatively correlated with 30~50 years old.The self-management behavior scale score,medication compliance,treatment satisfaction,quality of life,seizure frequency,symptom checklist,anxiety and depression score in the intervention group were better than those in the control group.After the intervention of self-management mode,the self-management score,treatment efficiency,quality of life and medication compliance of the intervention group were better than those of the control group.Conclusions The level of self-management of epilepsy patients in China is insufficient,and the influencing factors and intervention measures are single,lacking integrated intervention measures and management models based on different levels of individuals,families,medical system and society.It is suggested that the self-management model of epileptic patients should be constructed based on evidence to improve self-efficacy and self-management level.
作者
杨春松
张伶俐
杨亚亚
陶秋吉
俞丹
YANG Chunsong;ZHANG Lingli;YANG Yaya;TAO Qiuji;YU Dan(Department of Pharmacy/Evidence-based Pharmacy Center,West China Second Hospital,Sichuan University,Chengdu 610041,China;Key Laboratory of Birth Defects and Related Diseases of Women and Children,Sichuan University,Ministry of Education,Chengdu 610041,China;Department of Pediatric Neurology,West China Second Hospital,Sichuan University,Chengdu 610041,China)
出处
《癫痫杂志》
2023年第4期300-305,共6页
Journal of Epilepsy
基金
国家自然科学基金青年科学基金项目(72004151)
四川省科技计划项目(重点研发项目)(2020YFS0035)。
关键词
癫痫
自我管理
循证评价
Epilepsy
Self-management
Evidence-based evaluation
