Self-Management Support Interventions for Stroke Survivors: A Systematic Meta-Review.
Self-Management Support Interventions for Stroke Survivors: A Systematic Meta-Review.
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DOI：
10.1371/journal.pone.0131448
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Pinnock H
中科院分区：
文献类型：
--
作者：
Parke HL;Epiphaniou E;Pearce G;Taylor SJ;Sheikh A;Griffiths CJ;Greenhalgh T;Pinnock H
在促进长期疾病患者的自我管理方面有相当大的政策兴趣，但这些干预措施对中风患者是否有效仍不确定。对中风幸存者自我管理支持干预措施的证据进行系统荟萃评价，以告知医疗服务的提供。我们检索MEDLINE、EMBASE、CINAHL、PsychINFO、AMED、BNI、有效性综述摘要数据库和Cochrane系统综述数据库，以获取卒中幸存者自我管理支持干预措施的系统综述。使用R-AMSTAR工具评估质量，使用定制的数据提取表提取数据。我们对评论的发现进行了叙述综合。从12400篇文献中，我们选择了13篇系统综述（发表于2003-2012年），代表101项单独试验。虽然“自我管理”这个术语很少被使用，但自我管理支持的关键要素，如目标设定、行动计划和问题解决，是治疗康复干预的核心组成部分。我们发现高质量的证据支持在中风事件发生后不久进行康复治疗的情况下进行自我管理，导致短期（< 1年）日常生活基本活动和扩展活动的改善，并减少不良结果（依赖/死亡）。有一些证据表明，康复和解决问题的干预措施有助于重新融入社区。自我管理术语很少用于中风。然而，治疗康复目前成功地为中风幸存者和他们的照顾者提供了自我管理支持的元素，并改善了结果。未来的研究应该集中在管理长期幸存者的情感、医疗和社会任务上。
There is considerable policy interest in promoting self-management in patients with long-term conditions, but it remains uncertain whether these interventions are effective in stroke patients. Systematic meta-review of the evidence for self-management support interventions with stroke survivors to inform provision of healthcare services. We searched MEDLINE, EMBASE, CINAHL, PsychINFO, AMED, BNI, Database of Abstracts of Reviews for Effectiveness, and Cochrane Database of Systematic Reviews for systematic reviews of self-management support interventions for stroke survivors. Quality was assessed using the R-AMSTAR tool, and data extracted using a customised data extraction form. We undertook a narrative synthesis of the reviews' findings. From 12,400 titles we selected 13 systematic reviews (published 2003-2012) representing 101 individual trials. Although the term ‘self-management’ was rarely used, key elements of self-management support such as goal setting, action planning, and problem solving were core components of therapy rehabilitation interventions. We found high quality evidence that supported self-management in the context of therapy rehabilitation delivered soon after the stroke event resulted in short-term (< 1 year) improvements in basic and extended activities of daily living, and a reduction in poor outcomes (dependence/death). There is some evidence that rehabilitation and problem solving interventions facilitated reintegration into the community. Self-management terminology is rarely used in the context of stroke. However, therapy rehabilitation currently successfully delivers elements of self-management support to stroke survivors and their caregivers with improved outcomes. Future research should focus on managing the emotional, medical and social tasks of long-term survivorship.