学校教授的自我管理干预措施在儿童和青少年哮喘患者中的有效性：来自Cochrane系统综述和荟萃分析的结果
2019/02/19
摘要
前言：迄今为止，尚未有系统综述关注学校教授儿童和青少年哮喘患者自我管理技术的有效性研究。
方法：本文为干预性研究的一项系统综述。纳入标准为采用随机平行组设计并且从1995年开始以英文发表的研究。参与者为在其自己的学校环境中接受教育的5-18岁哮喘儿童。使用随机效应荟萃分析组合定量数据。
结果：纳入了33项结果评估研究。以学校为基础的干预措施可有效减少急诊就诊的频率（OR 0.70,95％CI 0.53-0.92;研究= 13），并且在降低住院率方面中等有效（标准化平均差异[SMD] -0.19,95％ CI -0.35至-0.04;研究= 6）。对三项研究的荟萃分析表明，干预方法可以减少限制活动的天数（SMD -0.30,95％CI -0.41至-0.18;研究= 3）。然而，关于以学校为基础的自我管理干预是否会影响减少学校缺勤的问题存在不确定性。
结论：学校教授哮喘儿童的自我管理干预措施减少了急性发作次数。我们的结论是，学校教授干预措施是改善儿童健康的重要方法。
Effectiveness of school-based self-management interventions for asthma among children and adolescents: findings from a Cochrane systematic review and meta-analysis.
Kneale D, Harris K, McDonald VM, Thomas J, Grigg J.
Abstract
INTRODUCTION:The evidence that teaching self-management techniques to children and young people with asthma in schools is effective has not, to date, been the subject of systematic review.
METHODS:We conducted a systematic review of intervention studies. Studies were eligible if they employed a randomised parallel-group design and were published in English from 1995 onwards. Participants included children with asthma aged 5-18 years who participated within their own school environment. Searches were conducted on the Cochrane Airways Group Specialised Register. Quantitative data were combined using random-effects meta-analyses.
RESULTS:Thirty-three outcome evaluation studies were included. School-based interventions were effective in reducing the frequency of emergency department visits (OR 0.70, 95% CI 0.53 to 0.92; studies=13), and moderately effective in reducing levels of hospitalisations (standardised mean differences [SMD] -0.19, 95% CI -0.35 to -0.04; studies=6). A meta-analysis of three studies suggest that the intervention approach could reduce the number of days of restricted activity (SMD -0.30, 95% CI -0.41 to -0.18; studies=3). However, there was uncertainty as to whether school-based self-management interventions impacted on reducing absences from school.
CONCLUSIONS:Self-management interventions for children with asthma delivered in schools reduce the number of acute episodes of healthcare usage. We conclude that the school environment is an important space for delivering interventions to improve children's health.
前言：迄今为止，尚未有系统综述关注学校教授儿童和青少年哮喘患者自我管理技术的有效性研究。
方法：本文为干预性研究的一项系统综述。纳入标准为采用随机平行组设计并且从1995年开始以英文发表的研究。参与者为在其自己的学校环境中接受教育的5-18岁哮喘儿童。使用随机效应荟萃分析组合定量数据。
结果：纳入了33项结果评估研究。以学校为基础的干预措施可有效减少急诊就诊的频率（OR 0.70,95％CI 0.53-0.92;研究= 13），并且在降低住院率方面中等有效（标准化平均差异[SMD] -0.19,95％ CI -0.35至-0.04;研究= 6）。对三项研究的荟萃分析表明，干预方法可以减少限制活动的天数（SMD -0.30,95％CI -0.41至-0.18;研究= 3）。然而，关于以学校为基础的自我管理干预是否会影响减少学校缺勤的问题存在不确定性。
结论：学校教授哮喘儿童的自我管理干预措施减少了急性发作次数。我们的结论是，学校教授干预措施是改善儿童健康的重要方法。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校)
(Thorax. 2019 Jan 27. pii: thoraxjnl-2018-211909. doi: 10.1136/thoraxjnl-2018-211909.)
(Thorax. 2019 Jan 27. pii: thoraxjnl-2018-211909. doi: 10.1136/thoraxjnl-2018-211909.)
Effectiveness of school-based self-management interventions for asthma among children and adolescents: findings from a Cochrane systematic review and meta-analysis.
Kneale D, Harris K, McDonald VM, Thomas J, Grigg J.
Abstract
INTRODUCTION:The evidence that teaching self-management techniques to children and young people with asthma in schools is effective has not, to date, been the subject of systematic review.
METHODS:We conducted a systematic review of intervention studies. Studies were eligible if they employed a randomised parallel-group design and were published in English from 1995 onwards. Participants included children with asthma aged 5-18 years who participated within their own school environment. Searches were conducted on the Cochrane Airways Group Specialised Register. Quantitative data were combined using random-effects meta-analyses.
RESULTS:Thirty-three outcome evaluation studies were included. School-based interventions were effective in reducing the frequency of emergency department visits (OR 0.70, 95% CI 0.53 to 0.92; studies=13), and moderately effective in reducing levels of hospitalisations (standardised mean differences [SMD] -0.19, 95% CI -0.35 to -0.04; studies=6). A meta-analysis of three studies suggest that the intervention approach could reduce the number of days of restricted activity (SMD -0.30, 95% CI -0.41 to -0.18; studies=3). However, there was uncertainty as to whether school-based self-management interventions impacted on reducing absences from school.
CONCLUSIONS:Self-management interventions for children with asthma delivered in schools reduce the number of acute episodes of healthcare usage. We conclude that the school environment is an important space for delivering interventions to improve children's health.
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检查行为改变技术的哮喘管理应用程序的系统评估
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ARIA Phase 4 (2018):采用移动技术改变变应性鼻炎和哮喘的多重发病率管理
