A meta-analysis of trials evaluating patient education and counseling for three groups of preventive health behaviors.
A meta-analysis of trials evaluating patient education and counseling for three groups of preventive health behaviors.
复制标题
对评估三组预防性健康行为的患者教育和咨询的试验进行荟萃分析。
DOI：
10.1016/s0738-3991(97)00037-2
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发表时间：
1997
影响因子：
3.5
通讯作者：
Mains,DA
中科院分区：
文献类型：
--
作者：
Mullen,PD;Simons-Morton,DG;Ramírez,G;Frankowski,RF;Green,LW;Mains,DA
目的检查患者教育和咨询对预防性健康行为的总体有效性，并检查改变特定类型行为的各种方法的效果。数据来源计算机化数据库（Medline、Healthline、论文摘要和心理学摘要）、1971-1994 年参考书目。搜索词（患者教育、患者依从性和自我护理）以及修饰语（评估和具体预防行为）。研究选择随机和非随机对照试验，测量临床环境中未诊断疾病的患者的行为。由多名审稿人筛选的摘要和检索研究；检索到的研究中有 13% 符合筛选标准。数据提取由多个观察者重复编码。数据合成根据行为是否成瘾以及所需的改变是否需要减去现有行为或添加新行为来对行为进行分组。吸烟/饮酒研究随机效应模型的加权平均效应大小为 0.61 (CI=0.45, 0.77)，营养/体重研究为 0.51 (CI=0.20, 0.82)，其他行为为 0.56 (CI=0.34, 0.77)，表明这些亚组的行为结果与零显着不同。三组的多元回归模型表明，使用行为技术，特别是自我监控，以及使用多种沟通渠道（例如媒体加个人沟通），对吸烟/酗酒和营养/体重组产生更大的影响。结论患者教育和咨询有助于行为改变，以实现疾病的一级预防。有些技术在改变特定行为方面比其他技术更有效。
ObjectivesTo examine the overall effectiveness of patient education and counseling on preventive health behaviors and to examine the effects of various approaches for modifying specific types of behaviors.Data sourcesComputerized databases (Medline, Healthline, Dissertation Abstracts, and Psychological Abstracts), bibliographies 1971–1994. Search terms (patient education, patient compliance, and self care) with modifiers (evaluation and specific preventive behaviors).Study selectionRandomized and non-randomized controlled trials measuring behavior in clinical settings with patients without diagnosed disease. Abstracts and retrieved studies screened by multiple reviewers; 13% of retrieved studies met screening criteria.Data extractionReplicated coding by multiple observers.Data synthesisBehaviors were grouped based on whether the behavior is addictive and whether the desired change required subtraction of existing behaviors or adding new behaviors. The weighted average effect size from a random effects model for smoking/alcohol studies was 0.61 (CI=0.45, 0.77), for nutrition/weight, 0.51 (CI=0.20, 0.82) and for other behaviors, 0.56 (CI =0.34, 0.77) indicating that the behavioral outcomes for these subgroups were significantly different from zero. Multiple regression models for the three groups indicated that using behavioral techniques, particularly self-monitoring, and using several communication channels, e.g., media plus personal communication, produces larger effects for the smoking/alcohol and nutrition/weight groups.ConclusionsPatient education and counseling contribute to behavior change for primary prevention of disease. Some techniques are more effective than others in changing specific behaviors.