The effects of chronic obstructive pulmonary disease self-management interventions on improvement of quality of life in COPD patients: A meta-analysis

被引:71
作者
Cannon, Danielle [1 ,2 ]
Buys, Nicholas [3 ]
Sriram, Krishna Bajee [2 ,4 ]
Sharma, Siddharth [5 ]
Morris, Norman [6 ]
Sun, Jing [1 ,2 ]
机构
[1] Menzies Hlth Inst Queensland, Gold Coast, Qld, Australia
[2] Griffith Univ, Sch Med, Gold Coast Campus, Gold Coast, Qld 4222, Australia
[3] Griffith Univ, Griffith Hlth Inst, Gold Coast, Qld, Australia
[4] Gold Coast Univ Hosp, Dept Resp Med, Gold Coast, Qld, Australia
[5] Gold Coast Univ Hosp, Gen Med Dept, Gold Coast, Qld, Australia
[6] Gold Coast Univ Hosp, Sch Allied Hlth Sci, Gold Coast, Qld, Australia
关键词
PROGRAM; REHABILITATION; STATEMENT; EDUCATION; DYSPNEA; CARE;
D O I
10.1016/j.rmed.2016.11.005
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
This article aimed to analyse the outcome of self-management randomised control trials and their impact upon chronic obstructive pulmonary disease patients' health outcomes using meta-analysis approach. PubMed, Scopus, CINAHL, Web of Science databases and Cochrane Library, were searched for articles between 1990 and December 2015 by two researchers. Self-management programs significantly improved patients' quality of life across all domains of the St George Respiratory Questionnaire (SGRQ) (activity -2.21 (95% CI: -3.61 to -0.80), p = 0.002; impact -3.30 (95% CI: -5.28 to -1.32), p = 0.001; symptoms -3.12 (95% CI: -4.94 to -1.03), p = 0.001; total -3.32 (95% CI: -4.60 to -2.04), p < 0.001), the six-minute walk test (-30.50 (95% CI: 3.32 to 57.68), p = 0.028), and across three domains of the chronic obstructive pulmonary disease self-efficacy scale (negative effect -1.22 (95% CI: -2.31 to -0.14), p = 0.027; physical exertion -1.27 (95% CI: -2.52 to -0.02), p = 0.047; behavioural risk factors -0.58 (95% CI: -0.99 to -0.16), p = 0.007). Subgroup analyses revealed that chronic obstructive pulmonary disease education (p < 0.01) was the strongest component with improvements on all aspects of the SGRQ and the six-minute walk test. Providing an exacerbation action plan significantly improved SGRQ activity and impact scores whilst exercise information had a positive effect on activity and symptom scores (p < 0.05). Interventions with a duration of less than five weeks (p < 0.05) significantly improved symptom and activity scores, in addition to the number of patient hospital admissions. Thus, self-management interventions are effective at improving the health outcomes of chronic obstructive pulmonary disease patients, especially when disease education is provided. (C) 2016 Elsevier Ltd. All rights reserved.
引用
收藏
页码:81 / 90
页数:10
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