自我管理方案對慢性腎臟病病人之成效:系統性文獻回顧

背景：慢性腎臟疾病（chronic kidney disease, CKD）照護為全球重要的健康議題之一。CKD從病發至變成末期腎病變（（End stage of renal disease, ESRD）期間可能長達數年之久，疾病即早介入管理，使慢性腎臟疾病不至於演變至ESRD是當今急需解決的議題。近來陸續有實證資料顯示自我管理方案可改善CKD病人的疾病自我管理行為、生理及心理方面問題，但缺乏系統性文獻回顧探討其整體成效。目的：透過系統性文獻回顧研究方法，探討自我管理方案對CKD病人於自我管理行為指標、生理指標、心理指標的成效。研究方法：本研究以系統性文獻回顧研究方式，搜尋self-management、chronic kidney disease之MeSH（medical subject headings）字詞及其同義字為關鍵字。於電子資料庫Cochrane Library、PubMed/MEDLINE、CINAHL、Proquest、web of science（WOS）、臺灣期刊論文索引系統及華藝線上圖書館七個電子資料庫，搜尋1970年1月至2016年11月以前發表之文獻，篩選後共評讀8篇研究，並採用Modify Jadad Scale評價文章品質。結果：系統性文獻回顧結果，多數研究顯示自我管理方案介入可顯著提升CKD病人的自我管理行為，顯著改善eGFR、SCr.等生理指標，心理指標則多數無顯著成效。結論：自我管理方案或可提升CKD病人的自我管理行為，改善生理指標，延緩腎功能惡化進展為ESRD，建議推廣自我管理方案於臨床CKD照護中。關鍵字：自我管理、慢性腎臟疾病、系統性文獻回顧。

關鍵字

自我管理；慢性腎臟疾病；系統性文獻回顧

並列摘要

Background: Chronic kidney disease (CKD) is an important health issue around the world. It would take years for CKD to go into End Stage Renal Disease (ESRD). Therefore, it is vital to find a solution for early intervention so as to delay disease progression. There have been many studies suggested that applying self-management program in CKD interventions can improve patient’s Self-management behavioral, physiological and psychological issues; however, limit information of systematic review to explore its overall effects and make available conclusions. Purpose: This study used a systematic review of the literature to explore self-management program in Self-management behavioral, physiological and psychological effectiveness. Method: Apply the methods of systematic review and keywords included self-management and chronic kidney disease which relatives and MeSH (medical subject headings) words. Articles search were conducted The Cochrane Library, PubMed/MEDLINE , CINAHL, Proquest, web of science (WOS) , PerioPath Index to Taiwan Periodical Literature System and Airiti Library. Articles were retrieved form January, 1970 to November , 2016. Finally, the eight literatures for final analysis. The quality of all articles selected were appraised using Modify Jadad Score. Result: This study find that self-management program interventions may could improve CKD patients in Self-management behavioral and physiological datas as well as eGFR, SCr.; nonetheless, psychological indicators efficacy were not have significant effects in this study . Conclusion: Self-management programs may can help CKD patients improve self-management behavioral and physiological indicators, then delay progressing of CKD. Suggest we can use Self-management program in clinical care for CKD patients Keywords: Self-management, CKD, systematic review

並列關鍵字

Self management ； CKD ； systematic review

參考文獻

Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychological review, 84(2), 191.

Chen, S. H., Tsai, Y. F., Sun, C. Y., Wu, I. W., Lee, C. C., & Wu, M. S. (2011). The impact of self-management support on the progression of chronic kidney disease-- A prospective randomized controlled trial. Nephrology Dialysis Transplantation, 26(11), 3560–3566. doi:10.1093/ndt/gfr047

Flesher, M., Woo, P., Chiu, A., Charlebois, A., Warburton, D. E., & Leslie, B. (2011). Self-management and biomedical outcomes of a cooking, and exercise program for patients with chronic kidney disease. Journal of Renal Nutrition, 21(2), 188–195. doi:10.1053/j.jrn.2010.03.009

丘周萍、盧永川、洪士元 (2016)•慢性腎臟疾病病人之自我管理•護理雜誌，63(2)，5-11。

Google Scholar

李育勤、吳淑芳、李梅琛、陳甫安、姚彥宏、王卿凌(2014)•以系統性文獻回顧方式建構慢性腎臟病之自我管理方案•護理雜誌，61(6)，66-77。

Google Scholar

國際替代計量

自我管理方案對慢性腎臟病病人之成效:系統性文獻回顧

未授權

主題瀏覽