HBM教育对透析患者的干预有效性的Meta分析

Meta-Analysis of Intervention Effectiveness of HBM Education in Dialysis Patients

摘要: 目的：对健康信念模式干预血液透析患者的健康信念、自我管理能力和液体摄入的影响进行系统评价。方法：检索PubMed、Web of Science、Embase、Cochrane Library、知网、维普、万方等大型数据库中对血液透析患者进行健康信念模式教育的随机对照试验，检索时限均从建库至今。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用RevMan5.4软件进行Meta分析。结果：共纳入12个随机对照试验，包括1610例患者。Meta分析结果显示：健康信念模式干预组在健康信念[SMD = 0.670, 95% CI (0.460~0.880), P < 0.001]、IDGW/干体重的比值[SMD = −0.660, 95% CI (−0.850~−0.470), P < 0.001]、自我管理能力[SMD = 1.350, 95% CI 1.070~1.630, P < 0.001]、生化指标[SMD = 0.420, 95% CI (−0.630~−0.210), P < 0.001]等方面结果数据指标均显示有较明显的差异。结论：透析中运用健康信念模式教育可增强患者自我管理能力，提高其生存质量。

Abstract: Objective: To systematically evaluate the effect of health belief model on health belief, self-management ability and fluid intake in hemodialysis patients. Methods: Randomized controlled trials of health belief model education in hemodialysis patients were searched in large databases such as Pub Med, Web of Science, Embase, Cochrane Library, CNKI, VIP, Wanfang, etc. The search time was from the estab-lishment of the database to the present. After literature screening, data extraction and the risk of bias in the included studies were independently evaluated by two reviewers, meta-analysis was performed using RevMan5.4 software. Results: A total of 12 randomized controlled trials were included, including 1610 patients. The results of meta-analysis showed: In the health belief pattern intervention group, the ratio of health belief [SMD = 0.670, 95% CI (0.460~0.880), P < 0.001], IDGW/dry weight [SMD = −0.660, 95% CI (−0.850~−0.470), P < 0.001], self-management ability [SMD = 1.350, 95% CI 1.070~1.630, P < 0.001], biochemical indexes [SMD = 0.420, 95% CI (−0.630~−0.210), P < 0.001] and other results showed significant differences. Conclusion: The use of health belief model education in dialysis can enhance patients’ self-management ability and improve their quality of life.