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虚拟护理对小儿糖尿病患者健康相关生活质量的影响:一项系统综述

The Impact of Virtual Care on Health-Related Quality of Life in Pediatric Diabetes Mellitus: A Systematic Review.

作者信息

Rajan Raeesha, Dovbenyuk Roman, Kshatriya Maya, Yanikomeroglu Sezgi, Banfield Laura, Athale Uma, Thabane Lehana, Samaan M Constantine

机构信息

Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.

Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada.

出版信息

Adolesc Health Med Ther. 2025 Feb 21;15:109-117. doi: 10.2147/AHMT.S482859. eCollection 2024.

Abstract

BACKGROUND

The COVID-19 pandemic has escalated the utilization of virtual care platforms in pediatric diabetes mellitus. The impact of these interventions on the health-related quality of life (HRQOL) is unclear.

OBJECTIVE

This systematic review evaluated the impact of virtual care, including eHealth and mHealth modalities, when compared to in-person care, on HRQOL in children with diabetes.

METHODS

MEDLINE, EMBASE, EMCare, PsycInfo, and Web of Science, ProQuest Dissertations and Theses A&I, and ClinicalTrials.gov databases and registries were searched from database inception to October 2, 2023. Randomized and non-randomized comparative studies were eligible for inclusion.

RESULTS

Thirteen studies were identified (12 randomized controlled trials, 1 cross-sectional study) involving 1566 children with type 1 diabetes mellitus (T1DM). The supplemental virtual care interventions utilized either web- or mobile-based platforms for intervention implementation. No interventions were detrimental to HRQOL, and a few improved the short-term HRQOL. No interventions worsened glycemic control. Patients and family's satisfaction with virtual care was high, perceiving it to be equal to or better than in-person care. There was no evidence for the use of virtual care and its effect on HRQOL in pediatric type 2 diabetes mellitus patients.

CONCLUSION

Virtual care is associated with a stable or improved HRQOL and patient and family satisfaction in pediatric T1DM. Decision makers need to consider expanding virtual access to pediatric diabetes care that can improve equitable access to quality care across healthcare systems globally.

摘要

背景

新冠疫情使儿科糖尿病虚拟护理平台的使用有所增加。这些干预措施对健康相关生活质量(HRQOL)的影响尚不清楚。

目的

本系统评价评估了与面对面护理相比,虚拟护理(包括电子健康和移动健康模式)对糖尿病儿童HRQOL的影响。

方法

检索了MEDLINE、EMBASE、EMCare、PsycInfo、科学网、ProQuest学位论文与学术期刊文摘数据库以及ClinicalTrials.gov数据库和注册库,检索时间从数据库建立至2023年10月2日。纳入随机和非随机对照研究。

结果

共纳入13项研究(12项随机对照试验,1项横断面研究),涉及1566例1型糖尿病(T1DM)儿童。补充性虚拟护理干预通过基于网络或移动的平台实施。没有干预措施对HRQOL有害,有一些干预措施改善了短期HRQOL。没有干预措施使血糖控制恶化。患者及其家属对虚拟护理的满意度很高,认为其等同于或优于面对面护理。没有证据表明虚拟护理对儿科2型糖尿病患者的HRQOL有影响。

结论

在儿科T1DM中,虚拟护理与稳定或改善的HRQOL以及患者和家属满意度相关。决策者需要考虑扩大儿科糖尿病护理的虚拟服务,这可以改善全球医疗系统中获得优质护理的公平性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37c3/11865916/667c7bd621f8/AHMT-15-109-g0001.jpg

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