The impact of Internet-based self-management interventions on health outcomes in middle-aged adults with type 2 diabetes: A systematic review
Başlık çevirisi mevcut değil.
- Tez No: 851556
- Danışmanlar: PROF. JACKİE STURT, DR. RİTA FORDE
- Tez Türü: Yüksek Lisans
- Konular: Hemşirelik, Nursing
- Anahtar Kelimeler: Belirtilmemiş.
- Yıl: 2018
- Dil: İngilizce
- Üniversite: Kıng S College London England
- Enstitü: Yurtdışı Enstitü
- Ana Bilim Dalı: Belirtilmemiş.
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: Belirtilmemiş.
Özet
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Özet (Çeviri)
Background Type 2 diabetes has become one of the most common chronic diseases, affecting nearly 415 million people with diabetes in 2015 (IDF 2017). Type 2 diabetes can lead to microvascular complications, namely peripheral neuropathy, diabetic retinopathy, and nephropathy; and macrovascular complications such as cardiac (ischemic heart disease) disease, and peripheral vascular disease (Ogurtsova et al. 2017). Middle-aged adults between 50 and 65 years old are the main population which is affected by type 2 diabetes (Li et al. 2016). Based on the increase of type 2 diabetes and the diabetes-associated complications, self-management strategies and implications of more effective treatment for middle-aged people are needed. The potential feasibility of delivering diabetes selfmanagement interventions via Internet programs presents an important opportunity for middle-aged adults for accessible health care. Objective The objective of this systematic review is to assess the impact of Internet-based selfmanagement interventions on health outcomes (HbA1c level, total cholesterol, blood pressure, diabetes distress, self-efficacy, and depression) in middle-aged adults with type 2 diabetes. Method The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidance and the Cochrane Handbook for Systematic Reviews of Interventions were followed for the preparation and development of this systematic review (Moher et al. 2009, Higgins & Green 2011). The systematic searches were conducted in three databases (MEDLINE, CINAHL, and EMBASE). The reference lists of included studies to collect all available data for this study were also scanned. For data collection, all searches were performed between February 2018 and 29th July 2018. In line with the PICO strategy, a facet analysis was carried out by dividing the question into the three parts. Eligibility criteria were defined before searching and eight RCTs were iii identified. RCTs selected in this review were appraised using Cochrane Collaboration's tool for assessing risk of bias (Higgins & Green 2011). Result Eight RCTs with 1760 participants were included in this review. A meta-analysis for the primary outcome (HbA1c) was performed using random effect model from the Review Manager Software (RevMan 5.3). The findings of this study demonstrated that Internetbased self-management education interventions resulted in the improvement of glycated haemoglobin A1c (HbA1c) (pooled mean difference on HbA1c: -0.35 (Unit: %), 95% CI [-0.52, —0.18], p<0.001). These results were clinically and statistically significant improvements in HbA1c (UKPDS 2000). A narrative synthesis was conducted for the secondary outcomes (blood pressure, total cholesterol, diabetes distress, depression, and self-efficacy). However, the current interventions did not demonstrate sufficient evidence for improving secondary outcomes. Conclusion Internet-based self-management education interventions significantly improve HbA1c values. Since such Internet-based interventions for type 2 diabetes represent tailored, patient centred, efficient, and quality care, healthcare professionals need to consider adopting them as self-care interventions for the care of type 2 diabetes. Although the present systematic review highlights the importance of the secondary outcomes that are of the utmost importance to increase the quality of life in individuals with type 2 diabetes, further research is needed to determine whether Internet-based selfmanagement interventions are effective in improving secondary outcomes in this review.
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