Health-Literacy-Sensitive Diabetes Self-Management Interventions: A Systematic Review and Meta-Analysis
Health-Literacy-Sensitive Diabetes Self-Management Interventions: A Systematic Review and Meta-Analysis
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DOI：
10.1111/wvn.12157
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发表时间：
2016-08-01
影响因子：
4.3
通讯作者：
Lee, Anna
中科院分区：
文献类型：
--
作者：
Kim, Su Hyun;Lee, Anna
背景健康素养低是糖尿病患者自我管理的潜在障碍。针对糖尿病自我管理干预措施，人们提出了多种针对低健康素养的策略，但适应低健康素养的干预措施在内容上存在异质性，并产生了不同的结果。目的系统回顾健康素养敏感的糖尿病管理干预措施，重点是确定适应低健康素养患者的策略，并检验这些干预措施改善健康结果的功效。方法检索PubMed、CINAHL和EMBASE的干预研究发表于 2000 年 1 月至 2015 年 1 月之间。两位作者根据纳入标准分别确定全文，并使用混合方法评估工具的定量成分评估研究质量。经过讨论，最终确定了待分析的研究清单。荟萃分析是使用随机效应模型进行的。结果我们从初步搜索中发现的 490 项研究中选出了 13 项研究。我们确定了一系列适应糖尿病自我管理干预措施的健康素养较低的策略，其中包括四个领域：书面交流、口头交流、赋权和语言/文化考虑。使用至少一种口头交流策略可以带来积极的认知/心理、自我保健和健康结果。我们发现，总体而言，荟萃分析中健康素养敏感的糖尿病管理干预措施可有效降低 HbA1C 水平。将证据与行动联系起来医疗保健提供者应考虑积极实施策略，以适应糖尿病自我管理干预措施中健康素养较低的人群。日常使用口头沟通策略对于在糖尿病自我管理干预中实现最佳健康结果是必要的。需要更多的研究来确定改善健康和减少健康差距的关键策略对个体的影响。
BackgroundLow health literacy is a potential barrier to self-management among patients with diabetes. A variety of strategies for low health literacy have been proposed for diabetes self-management interventions, but interventions accommodating low health literacy have been heterogeneous in terms of content and have produced mixed results.AimTo systematically review health-literacy-sensitive diabetes management interventions, with a focus on identifying strategies for accommodating patients with low health literacy, and to examine the efficacy of these interventions to improve health outcomes.MethodsPubMed, CINAHL, and EMBASE were searched for intervention studies published between January 2000 and January 2015. Two authors separately identified full-texts according to the inclusion criteria and assessed study quality using the quantitative components of the Mixed Methods Appraisal Tool. The final list of studies to be analyzed was made through discussion. The meta-analysis was conducted using a random effects model.ResultsThirteen studies were selected from the 490 studies found in our initial search. We identified a range of strategies for accommodating those with low health literacy in diabetes self-management interventions, which encompassed four domains: written communication, spoken communication, empowerment, and language/cultural consideration. Using at least one of the spoken communication strategies led to positive cognitive/psychological, self-care, and health outcomes. We found that, overall, health-literacy-sensitive diabetes management interventions were effective in reducing HbA1C level in the meta-analysis.Linking Evidence to ActionHealthcare providers should consider active implementation of strategies for accommodating people with low health literacy in diabetes self-management interventions. The routine use of spoken communication strategies would be necessary to achieve the best health outcomes in diabetes self-management interventions. More research is needed to determine the individual effects of the key strategies that improve health and reduce health disparity.