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Blunted cardiovascular reactivity to psychological stress and prospective health: a systematic review. 钝化心血管对心理压力的反应与预期健康:一项系统综述。
IF 9.8 1区 心理学 Q1 Psychology Pub Date : 2023-03-01 DOI: 10.1080/17437199.2022.2068639
Adam O' Riordan, Siobhán Howard, Stephen Gallagher

Novel research demonstrates that lower or 'blunted' cardiovascular reactions to stress are associated with a range of adverse outcomes. The aim of the current review was (1) to examine the prospective outcomes predicted by blunted cardiovascular reactivity and (2) to identify a range of blunted cardiovascular reaction levels that predict these outcomes. Electronic databases were systematically searched (Medline, PsycArticles, PsycInfo, CINAHL, PubMed, Web of Science). Studies were included if they examined the prospective influence of blunted cardiovascular reactivity to psychological stress (SBP, DBP or HR) on a negative health, behavioural or psychological outcome. A total of 23 studies were included in the review. Blunted reactivity predicted (1) adverse cardiovascular health, primarily in cardiac samples (e.g., myocardial infarction, carotid atherosclerosis) and (2) outcomes associated with motivational and behavioural dysregulation in healthy samples (e.g., obesity, smoking addiction, depression). The cardiovascular reactivity threshold levels that were predictive of adverse health outcomes ranged between -3.00-12.59 bpm (14.41% to 136.59% lower than the sample mean) and -2.4-5.00 mmhg (65.99% to 133.80% lower than sample mean), for HR and DBP respectively. We posit that blunted reactions lower than, or equal to, the ranges reported here may be utilised by clinicians and researchers to identify individuals who are at increased risk of adverse cardiovascular health outcomes, as well as outcomes associated with motivational and behavioural dysregulation.

新的研究表明,心血管对压力的反应较低或“迟钝”与一系列不良后果有关。本综述的目的是:(1)检查由钝化心血管反应预测的前瞻性结果,(2)确定预测这些结果的钝化心血管反应水平的范围。系统检索电子数据库(Medline, PsycArticles, PsycInfo, CINAHL, PubMed, Web of Science)。如果研究考察了心血管对心理压力反应减弱(收缩压、舒张压或心率)对健康、行为或心理结果的负面影响,则纳入研究。该综述共纳入了23项研究。钝化的反应性预测(1)心血管健康不良,主要是在心脏样本中(如心肌梗死、颈动脉粥样硬化)和(2)健康样本中与动机和行为失调相关的结果(如肥胖、吸烟成瘾、抑郁)。预测不良健康结果的心血管反应性阈值水平分别为-3.00-12.59 bpm(比样本平均值低14.41% - 136.59%)和-2.4-5.00 mmhg(比样本平均值低65.99% - 133.80%)。我们假设,低于或等于本文报道的范围的钝化反应可能被临床医生和研究人员用来识别心血管健康不良后果风险增加的个体,以及与动机和行为失调相关的后果。
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引用次数: 13
Social Safety Theory: Conceptual foundation, underlying mechanisms, and future directions. 社会安全理论:概念基础、潜在机制和未来方向。
IF 6.6 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2023-03-01 Epub Date: 2023-03-30 DOI: 10.1080/17437199.2023.2171900
George M Slavich, Lydia G Roos, Summer Mengelkoch, Christian A Webb, Eric C Shattuck, Daniel P Moriarity, Jenna C Alley

Classic theories of stress and health are largely based on assumptions regarding how different psychosocial stressors influence biological processes that, in turn, affect human health and behavior. Although theoretically rich, this work has yielded little consensus and led to numerous conceptual, measurement, and reproducibility issues. Social Safety Theory aims to address these issues by using the primary goal and regulatory logic of the human brain and immune system as the basis for specifying the social-environmental situations to which these systems should respond most strongly to maximize reproductive success and survival. This analysis gave rise to the integrated, multi-level formulation described herein, which transforms thinking about stress biology and provides a biologically based, evolutionary account for how and why experiences of social safety and social threat are strongly related to health, well-being, aging, and longevity. In doing so, the theory advances a testable framework for investigating the biopsychosocial roots of health disparities as well as how health-relevant biopsychosocial processes crystalize over time and how perceptions of the social environment interact with childhood microbial environment, birth cohort, culture, air pollution, genetics, sleep, diet, personality, and self-harm to affect health. The theory also highlights several interventions for reducing social threat and promoting resilience.

压力和健康的经典理论在很大程度上是基于关于不同的心理社会压力源如何影响生物过程的假设,而生物过程又反过来影响人类的健康和行为。尽管理论丰富,但这项工作几乎没有达成共识,并导致了许多概念、测量和再现性问题。社会安全理论旨在通过使用人类大脑和免疫系统的主要目标和调节逻辑作为基础来解决这些问题,以确定这些系统应对最强烈的社会环境状况,从而最大限度地提高生殖成功和生存率。这一分析产生了本文所述的综合、多层次的表述,它改变了对压力生物学的思考,并为社会安全和社会威胁的体验如何以及为什么与健康、幸福、衰老和寿命密切相关提供了一个基于生物学的进化解释。在这样做的过程中,该理论提出了一个可测试的框架,用于调查健康差异的生物心理社会根源,以及与健康相关的生物心理过程如何随着时间的推移而结晶,以及对社会环境的感知如何与儿童微生物环境、出生队列、文化、空气污染、遗传、睡眠、饮食、个性和自残相互作用,从而影响健康。该理论还强调了减少社会威胁和提高复原力的几种干预措施。
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引用次数: 0
Mental contrasting with implementation intentions as a technique for media-mediated persuasive health communication. 心理对比与实施意图:媒介媒介劝导健康传播的一种技巧。
IF 9.8 1区 心理学 Q1 Psychology Pub Date : 2022-12-01 DOI: 10.1080/17437199.2021.1988866
Alexander Ort, Andreas Fahr

Mental Contrasting with Implementation Intentions (MCII) is a self-regulation strategy that combines the strategies mental contrasting (MC) in which individualscontrast a desired future with the current reality with the strategy of forming implementation intentions (II), which involves making concrete if-then plans (implementation intentions, II) to overcome the obstacles standing in the way of the desired future. Numerous studies across behavioral domains have demonstrated the effectiveness of this strategy in supporting people to adopt health-promoting behaviors or changing unhealthy behaviors. However, research on MCII has so far neglected the applicability of the concept in media-mediated persuasive health communication. This conceptual review aims to demonstrate and examine the potentials and effects of MCII as a technique to tailor media-mediated persuasive health messages and their dissemination through different media channels. In doing so, it draws on existing models of health behavior change, especially individuals' threat and coping appraisals. Potential effects of MCII on these cognitive factors are discussed, and practical implications for health message design are outlined.

实施意向心理对比(MCII)是一种自我调节策略,它将个体将期望的未来与当前现实进行对比的心理对比策略(MC)与形成实施意向策略(II)相结合,其中包括制定具体的“如果-那么”计划(实施意向,II),以克服阻碍实现期望的未来的障碍。跨行为领域的大量研究已经证明了这一策略在支持人们采取促进健康的行为或改变不健康行为方面的有效性。然而,到目前为止,对mci的研究忽视了这一概念在媒体介导的说服性健康传播中的适用性。本概念性综述旨在证明和检验mci作为一种技术的潜力和效果,以定制媒体介导的有说服力的健康信息及其通过不同媒体渠道的传播。在此过程中,它借鉴了现有的健康行为改变模型,特别是个人的威胁和应对评估。本文讨论了MCII对这些认知因素的潜在影响,并概述了健康信息设计的实际意义。
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引用次数: 6
White Paper: Open Digital Health - accelerating transparent and scalable health promotion and treatment. 白皮书:开放的数字健康——加速透明和可扩展的健康促进和治疗。
IF 9.8 1区 心理学 Q1 Psychology Pub Date : 2022-12-01 DOI: 10.1080/17437199.2022.2046482
Dominika Kwasnicka, Jan Keller, Olga Perski, Sebastian Potthoff, Gill A Ten Hoor, Ben Ainsworth, Rik Crutzen, Simone Dohle, Anne van Dongen, Matti Heino, Julia F Henrich, Liam Knox, Laura M König, Wendy Maltinsky, Claire McCallum, Judith Nalukwago, Efrat Neter, Johanna Nurmi, Manuel Spitschan, Samantha B Van Beurden, L Nynke Van der Laan, Kathrin Wunsch, Jasper J J Levink, Robbert Sanderman

In this White Paper, we outline recommendations from the perspective of health psychology and behavioural science, addressing three research gaps: (1) What methods in the health psychology research toolkit can be best used for developing and evaluating digital health tools? (2) What are the most feasible strategies to reuse digital health tools across populations and settings? (3) What are the main advantages and challenges of sharing (openly publishing) data, code, intervention content and design features of digital health tools? We provide actionable suggestions for researchers joining the continuously growing Open Digital Health movement, poised to revolutionise health psychology research and practice in the coming years. This White Paper is positioned in the current context of the COVID-19 pandemic, exploring how digital health tools have rapidly gained popularity in 2020-2022, when world-wide health promotion and treatment efforts rapidly shifted from face-to-face to remote delivery. This statement is written by the Directors of the not-for-profit Open Digital Health initiative (n = 6), Experts attending the European Health Psychology Society Synergy Expert Meeting (n = 17), and the initiative consultant, following a two-day meeting (19-20th August 2021).

在本白皮书中,我们从健康心理学和行为科学的角度概述了建议,解决了三个研究空白:(1)健康心理学研究工具包中的哪些方法最适合用于开发和评估数字健康工具?(2)在人群和环境中重用数字卫生工具的最可行策略是什么?(3)共享(公开发布)数字健康工具的数据、代码、干预内容和设计特征的主要优势和挑战是什么?我们为参与持续增长的开放数字健康运动的研究人员提供可操作的建议,准备在未来几年彻底改变健康心理学的研究和实践。本白皮书定位于2019冠状病毒病大流行的当前背景,探讨数字卫生工具如何在2020-2022年迅速普及,当时全球健康促进和治疗工作迅速从面对面转向远程提供。本声明由非营利性开放数字健康倡议的主任(n = 6)、参加欧洲健康心理学学会协同专家会议的专家(n = 17)和倡议顾问在为期两天的会议(2021年8月19日至20日)之后撰写。
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引用次数: 12
Understanding health behaviours in context: A systematic review and meta-analysis of ecological momentary assessment studies of five key health behaviours. 理解环境中的健康行为:对五种关键健康行为的生态瞬时评估研究的系统回顾和荟萃分析。
IF 9.8 1区 心理学 Q1 Psychology Pub Date : 2022-12-01 DOI: 10.1080/17437199.2022.2112258
Olga Perski, Jan Keller, Dimitra Kale, Bernard Yeboah-Asiamah Asare, Verena Schneider, Daniel Powell, Felix Naughton, Gill Ten Hoor, Peter Verboon, Dominika Kwasnicka

Ecological Momentary Assessment (EMA) involves repeated, real-time sampling of health behaviours in context. We present the state-of-knowledge in EMA research focused on five key health behaviours (physical activity and sedentary behaviour, dietary behaviour, alcohol consumption, tobacco smoking, sexual health), summarising theoretical (e.g., psychological and contextual predictors) and methodological aspects (e.g., study characteristics, EMA adherence). We searched Ovid MEDLINE, Embase, PsycINFO and Web of Science until February 2021. We included studies focused on any of the aforementioned health behaviours in adult, non-clinical populations that assessed ≥1 psychological/contextual predictor and reported a predictor-behaviour association. A narrative synthesis and random-effects meta-analyses of EMA adherence were conducted. We included 633 studies. The median study duration was 14 days. The most frequently assessed predictors were 'negative feeling states' (21%) and 'motivation and goals' (16.5%). The pooled percentage of EMA adherence was high at 81.4% (95% CI = 80.0%, 82.8%, k = 348) and did not differ by target behaviour but was somewhat higher in student (vs. general population) samples, when EMAs were delivered via mobile phones/smartphones (vs. handheld devices), and when event contingent (vs. fixed) sampling was used. This review showcases how the EMA method has been applied to improve understanding and prediction of health behaviours in context.

生态瞬时评估(EMA)涉及对环境中的健康行为进行重复的实时采样。我们介绍了EMA研究的现状,重点关注五种关键健康行为(身体活动和久坐行为、饮食行为、饮酒、吸烟、性健康),总结了理论(如心理和背景预测因素)和方法方面(如研究特征、EMA依从性)。我们检索了Ovid MEDLINE, Embase, PsycINFO和Web of Science,直到2021年2月。我们纳入了针对成人、非临床人群中任何上述健康行为的研究,这些研究评估了≥1个心理/环境预测因子,并报告了预测因子-行为关联。对EMA依从性进行叙事综合和随机效应荟萃分析。我们纳入了633项研究。中位研究持续时间为14天。最常被评估的预测因素是“消极情绪状态”(21%)和“动机和目标”(16.5%)。EMA依从性的总百分比高达81.4% (95% CI = 80.0%, 82.8%, k = 348),并没有因目标行为而异,但在学生(与一般人群)样本中,当通过移动电话/智能手机(与手持设备相比)提供EMA时,以及当使用事件偶然抽样(与固定抽样相比)时,EMA依从性的总百分比略高。这篇综述展示了EMA方法是如何应用于提高对环境中健康行为的理解和预测的。
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引用次数: 11
A systematic review and meta-analysis of studies of reactivity to digital in-the-moment measurement of health behaviour. 对健康行为即时数字测量反应性研究的系统回顾和荟萃分析。
IF 9.8 1区 心理学 Q1 Psychology Pub Date : 2022-12-01 DOI: 10.1080/17437199.2022.2047096
Laura M König, Anila Allmeta, Nora Christlein, Miranda Van Emmenis, Stephen Sutton

Self-report measures of health behaviour have several limitations including measurement reactivity, i.e., changes in people's behaviour, cognitions or emotions due to taking part in research. This systematic review investigates whether digital in-the-moment measures induce reactivity to a similar extent and why it occurs. Four databases were searched in December 2020. All observational or experimental studies investigating reactivity to digital in-the-moment measurement of a range of health behaviours were included if they were published in English in 2008 or later. Of the 11,723 records initially screened, 30 publications reporting on 31 studies were included in the qualitative synthesis/ 7 studies in the quantitative synthesis. Eighty-one percent of studies focused on reactivity to the measurement of physical activity indicators; small but meaningful pooled effects were found (Cohen's ds: 0.27-0.30). Only a small number of studies included other behaviours, yielding mixed results. Digital in-the-moment measurement of behaviour thus may be as prone to reactivity as self-reports in questionnaires. Measurement reactivity may be amplified by (1) ease of changing the behaviour (2) awareness of being measured and social desirability, and (3) resolving discrepancies between actual and desired behaviour through self-regulation.

健康行为的自我报告措施有一些局限性,包括测量反应性,即由于参加研究而使人们的行为、认知或情绪发生变化。这篇系统综述调查了数字即时测量是否会引起类似程度的反应,以及为什么会发生。2020年12月检索了四个数据库。所有调查对一系列健康行为的数字化即时测量的反应性的观察性或实验性研究,如果它们在2008年或之后以英文发表,都被包括在内。在最初筛选的11723份记录中,30份报告了31项研究的出版物被纳入定性综合,7项研究被纳入定量综合。81%的研究关注的是对身体活动指标测量的反应;发现小但有意义的合并效应(Cohen’s ds: 0.27-0.30)。只有少数研究包括了其他行为,结果好坏参半。因此,对行为的数字化即时测量可能与问卷中的自我报告一样容易产生反应。测量反应性可以通过以下方式被放大:(1)改变行为的便利性;(2)被测量的意识和社会期望;(3)通过自我调节解决实际行为和期望行为之间的差异。
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引用次数: 10
Characteristics of smartphone-based dietary assessment tools: a systematic review. 基于智能手机的饮食评估工具的特点:一项系统综述。
IF 9.8 1区 心理学 Q1 Psychology Pub Date : 2022-12-01 DOI: 10.1080/17437199.2021.2016066
Laura M König, Miranda Van Emmenis, Johanna Nurmi, Aikaterini Kassavou, Stephen Sutton

Smartphones have become popular in assessing eating behaviour in real-life and real-time. This systematic review provides a comprehensive overview of smartphone-based dietary assessment tools, focusing on how dietary data is assessed and its completeness ensured. Seven databases from behavioural, social and computer science were searched in March 2020. All observational, experimental or intervention studies and study protocols using a smartphone-based assessment tool for dietary intake were included if they reported data collected by adults and were published in English. Out of 21,722 records initially screened, 117 publications using 129 tools were included. Five core assessment features were identified: photo-based assessment (48.8% of tools), assessed serving/ portion sizes (48.8%), free-text descriptions of food intake (42.6%), food databases (30.2%), and classification systems (27.9%). On average, a tool used two features. The majority of studies did not implement any features to improve completeness of the records. This review provides a comprehensive overview and framework of smartphone-based dietary assessment tools to help researchers identify suitable assessment tools for their studies. Future research needs to address the potential impact of specific dietary assessment methods on data quality and participants' willingness to record their behaviour to ultimately improve the quality of smartphone-based dietary assessment for health research.

智能手机在现实生活和实时评估饮食行为方面已经变得很流行。本系统综述提供了基于智能手机的饮食评估工具的全面概述,重点关注如何评估饮食数据及其完整性。2020年3月,研究人员对行为、社会和计算机科学领域的七个数据库进行了搜索。所有使用基于智能手机的饮食摄入评估工具的观察性、实验性或干预性研究和研究方案,如果它们报告的数据是由成年人收集的,并以英语发表,则都被纳入其中。在最初筛选的21,722份记录中,使用129种工具纳入了117份出版物。确定了五个核心评估特征:基于照片的评估(48.8%的工具),评估的服务/份量(48.8%),食物摄入的自由文本描述(42.6%),食物数据库(30.2%)和分类系统(27.9%)。平均而言,一个工具使用两个功能。大多数研究没有实现任何功能来提高记录的完整性。本综述提供了基于智能手机的饮食评估工具的全面概述和框架,以帮助研究人员为他们的研究确定合适的评估工具。未来的研究需要解决特定饮食评估方法对数据质量和参与者记录其行为的意愿的潜在影响,以最终提高基于智能手机的健康研究饮食评估的质量。
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引用次数: 16
Analysis of dynamic psychological processes to understand and promote physical activity behaviour using intensive longitudinal methods: a primer. 动态心理过程分析,以了解和促进使用密集的纵向方法的身体活动行为:初级读本。
IF 9.8 1区 心理学 Q1 Psychology Pub Date : 2022-12-01 DOI: 10.1080/17437199.2021.1987953
Geralyn R Ruissen, Bruno D Zumbo, Ryan E Rhodes, Eli Puterman, Mark R Beauchamp

Physical activity behaviour displays temporal variability, and is influenced by a range of dynamic psychological processes (e.g., affect) and shaped by various co-occurring events (e.g., social/environmental factors, interpersonal dynamics). Yet, most physical activity research tends not to examine the dynamic psychological processes implicated in adopting and maintaining physical activity. Intensive longitudinal methods (ILM) represent one particularly salient means of studying the complex psychological dynamics that underlie and result from physical activity behaviour. With the increased recent interest in using intensive longitudinal data to understand specific dynamic psychological processes, the field of exercise and health psychology is well-positioned to draw from state-of-the-art measurement and statistical approaches that have been developed and operationalised in other fields of enquiry. The purpose of this review is to provide an overview of some of the fundamental dynamic measurement and modelling approaches applicable to the study of physical activity behaviour change, as well as the dynamic psychological processes that contribute to such change.

身体活动行为表现出时间变异性,受到一系列动态心理过程(例如,情感)的影响,并受到各种共同发生的事件(例如,社会/环境因素,人际动态)的影响。然而,大多数体育活动研究往往不考察动态的心理过程涉及采取和维持体育活动。密集纵向方法(ILM)是研究身体活动行为背后和结果的复杂心理动力学的一种特别突出的方法。随着最近人们对使用密集的纵向数据来理解特定的动态心理过程的兴趣的增加,运动和健康心理学领域很好地定位于从最先进的测量和统计方法中汲取,这些方法已经在其他研究领域得到了发展和应用。本综述的目的是概述一些基本的动态测量和建模方法,适用于研究体育活动行为的改变,以及动态的心理过程,有助于这种变化。
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引用次数: 8
Training diabetes healthcare practitioners in motivational interviewing: a systematic review. 培训糖尿病保健从业人员在动机性访谈:一个系统的回顾。
IF 9.8 1区 心理学 Q1 Psychology Pub Date : 2022-09-01 Epub Date: 2021-05-24 DOI: 10.1080/17437199.2021.1926308
Tracey Kaczmarek, David J Kavanagh, Peter A Lazzarini, Jason Warnock, Jaap J Van Netten

Diabetes presents significant self-care challenges that require sustained motivation. Motivational Interviewing (MI) has substantial support in enhancing motivation for behavioural change, but its effective application in routine healthcare requires practitioners to acquire and use related skills. The aim of this systematic review was to investigate the impact of MI training on MI-related skills of practitioners who provide diabetes healthcare. PubMed, EMBASE and PsycINFO were searched using the terms motivational interviewing, motivation enhancement, and diabetes. Two assessors independently screened titles, abstracts and full texts for papers reporting the impact of MI training on diabetes healthcare practitioners' outcomes. Of 625 abstracts screened, 22 papers from 17 unique studies were included. All 17 studies reported some improvement in MI skills, with 14 finding improvements in more than 50% and three less than 35%. However, the risk of bias and outcome measures varied widely between studies. All studies showed diabetes healthcare practitioners acquired and applied MI skills post-training, to varying levels. Findings suggest training should include education, role play, and ongoing supervision to maintain skills.

糖尿病对自我保健提出了重大挑战,需要持续的动力。动机性访谈(MI)在增强行为改变的动机方面有很大的支持,但它在常规医疗保健中的有效应用需要从业人员获得和使用相关技能。本系统综述的目的是调查心肌梗死培训对提供糖尿病保健的从业人员心肌梗死相关技能的影响。PubMed, EMBASE和PsycINFO使用术语动机访谈,动机增强和糖尿病进行搜索。两名评估员独立筛选了报道心肌梗死培训对糖尿病医护人员结果影响的论文的标题、摘要和全文。在筛选的625篇摘要中,包括来自17项独特研究的22篇论文。所有17项研究都报告了MI技能的一些改善,其中14项研究发现改善超过50%,3项研究发现改善不到35%。然而,不同研究的偏倚风险和结果测量差异很大。所有的研究都表明,糖尿病医护人员在培训后获得并应用了不同程度的心肌梗死技能。研究结果表明,培训应包括教育、角色扮演和持续监督,以保持技能。
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引用次数: 6
What sixty years of research says about the effectiveness of patient education on health: a second order meta-analysis. 60年的研究表明病人健康教育的有效性:一个二级元分析。
IF 9.8 1区 心理学 Q1 Psychology Pub Date : 2022-09-01 Epub Date: 2021-08-24 DOI: 10.1080/17437199.2021.1967184
Bianca A Simonsmeier, Maja Flaig, Thomas Simacek, Michael Schneider

Although meta-analyses have examined the association between patient education and health, the validity and quality of this evidence have not been comprehensively assessed. This second order meta-analysis combined previous meta-analyses that examined the effectiveness of patient education on health outcomes as an overall weighted grand mean d¯¯. Further, measures of methodological quality, meaningful variability across first order meta-analyses, and evidence for publication bias were examined. Forty meta-analyses were identified, investigating 156 associations between patient education and health summarizing data from over 776 studies including more than 74.947 patients. Quantitative analyses showed that patient education positively affects health outcomes with d¯¯ = 0.316 (95% CI [0.304, 0.329]). Summarizing data exclusively from randomized controlled trials indicated a causal effect. Patient education was effective for patients with neoplasms, diabetes, mental and behavioral disorders, diseases of the circulatory system, the respiratory system, and the musculoskeletal system. Patient education was effective in the reduction of medication use, pain, and visits to medical facilities, and significantly improved physiological, physical, psychological outcomes, and patients' general function. Overall, the findings reveal firm evidence for the effectiveness of patient education on health outcomes. However, theory-based interventions are lacking and need to be implemented to enable a successful transfer from theory to practice.

虽然荟萃分析研究了患者教育与健康之间的关系,但这一证据的有效性和质量尚未得到全面评估。这个二级荟萃分析结合了以前的荟萃分析,这些荟萃分析检验了患者教育对健康结果的有效性,作为总体加权大平均值d¯¯。此外,还对方法学质量、一阶元分析中有意义的变异性和发表偏倚的证据进行了检验。我们确定了40项荟萃分析,调查了156项患者教育与健康之间的关联,总结了超过776项研究的数据,其中包括超过74947名患者。定量分析显示,患者教育对健康结局有积极影响,d¯¯= 0.316 (95% CI[0.304, 0.329])。总结随机对照试验的数据表明存在因果关系。患者教育对肿瘤、糖尿病、精神和行为障碍、循环系统疾病、呼吸系统疾病和肌肉骨骼系统疾病的患者是有效的。患者教育在减少药物使用、疼痛和医疗设施就诊方面是有效的,并显著改善了生理、身体、心理结果和患者的一般功能。总的来说,研究结果为患者教育对健康结果的有效性提供了确凿的证据。然而,缺乏以理论为基础的干预措施,需要实施以实现从理论到实践的成功转移。
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引用次数: 17
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