| Objective:We conducted a meta-analysis of randomised control trials and the empirical research of community intervention to evaluate the effectiveness and analyse the influencing factors of psychological and behavior intervention in patients with type 2diabetes mellitus.The purpose of this study was to provide scientific basis for selection and optimization of the management and intervention methods in patients with type 2 diabetes mellitus in China.Content and methods:1.Meta-analysis of psychological and behavior intervention in patients with type2 diabetes mellitus:We systematically reviewed published randomized controlled trials that assessed the effectiveness of psychological and behavior to patients with type 2diabetes mellitus,using electronic databases(the CNKI,Wanfang and VIP databases)from January 2005 to June 2015.Measurement data using standardized mean difference(SMD) as the ES,count data using the RR value as the ES, the heterogeneity test to all of the leteratures was made and sensitivity analysis was used.The subgroup analysis of the intervention duration,family and social support,inter-subject was further anslyzed.2. An empirical study of psychological behavior intervention in patients with type2 diabetes mellitus in a community of Fuzhou:Choosing 61 patients with type 2diabetes mellitus(course of disease?1year;the patients with type 2 diabetes mellitus or Only merge hypertension,being voluntary to participate in this study) from a certain community of cangshan district, in fuzhou,the psychological behavior intervention self-control study was made.The mode of psychological behavior intervention including cognitive intervention,psychological and behavioral intervention;intervention time for 3 months.The glycated hemoglobin level was detected and the questionnaire survey that includes basic status surveying form,adherence scale and self-rating depression scale was filled out before and after the intervention.The comparison of Hb A1 c,depression score,adherence and the five dimensions of adherence before and after intervention used matched t test.The influencing factors of intervention included gender, age, duration, etc.Single factor analysis used chi-square test.Multiple factors analysis used binary logistic regression analysis for the influencing factors of psychological behavior intervention effect.Results:1.The result of meta-analysis of psychological and behavior intervention in patients with type 2 diabetes mellitus:(1) Meta-analysis suggested that there were significant difference between the psychological and behavior intervention groups and the control group for Hb A1 c [SMD=-1.157,95%CI:(-1.477,-0.837),P <0.01] and the effective rate depression controlled [RR=1.691,95%CI:( 1.447,1.976),P<0.01].(2)The subgroup analysis suggested that there were significant difference between the psychological and behavior intervention groups and the control group(P<0.05)2.The result of self-control study of psychological and behavior intervention in patients with type 2 diabetes mellitus:(1)Before the intervention for Hb A1 c values was 7.42±1.55,Hb A1 c values after intervention was 6.70±1.05,there was significant difference between before and after the intervention( P<0.01).(2))Before the intervention for the SDS scores was 45.20±10.32,the scores after intervention was28.01±5.54,there was significant difference between before and after the intervention(P<0.01).(3)Before the intervention for the adherence score was 45.40±5.94,the scores after intervention was 54.85 ± 5.45,there was significant difference between before and after the intervention( P<0.01);the five dimensions of adherence(the medication compliance, the dietary adherence,the compliance with movement,the blood glucose self test compliance and the regular review of compliance) there were significant difference between before and after the intervention(P<0.01)3.The result of influencing factors study of psychological and behavior intervention in patients with type 2 diabetes mellitus:(1)There were significant difference in Hb A1 c before the intervention values and the types of the drugs for Hb A1c(P<0.01),there were no significant difference among other factors(P>0.05).(2)There was significant difference in course of disease for depression(P<0.01),there were no significant difference among other factors(P>0.05).(3)There were no significant difference in all factors for the adherence(P>0.05).(4)The result of multiple factors analysis shown:there is a close relationship in Hb A1 c before intervention for Hb A1c;there is a close relationship in course of disease and adherence scores before intervention.Suggestion:The psychological and behavior intervention for people with type 2 diabetes mellitus should be paid highly attention and further strengthening psychological behavior intervention research and extension should be in a planned way.Optimal selection of psychological behavior intervention plan will be made according to actual situationConclusions:1.It is certain about the effectiveness of psychological and behavior intervention in patients with type 2 diabetes mellitus.The effect of different means of intervention( duration,family and social support,and inter-subject) of psychological and behavior intervention in patients with type 2 diabetes mellitus may not be the same.2.That planned and strengthen professional psychological behavior intervention to improve glycemic control in type 2 diabetes, compliance and depressive mood has obvious effect,should be worthy of attention.3.Hb A1 c values before the intervention is a very important influencing factor of psychological behavior intervention;course of disease and the adherence score before the intervention are very important influencing factors to Improving the depression. |
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