Explore the evidence from randomized controlled trials for the effect of self-management interventions on quality of life, self-management skills and self-efficacy, and to explore which intervention characteristics are associated with effectiveness.

Design

Systematic review.

Data sources

A search of the literature was conducted in these databases: MEDLINE (OVID), EMBASE (OVID) and PsychINFO (OVID) from January 2000 to February 2020.

Review methods

Studies were included if participants had a bowel stoma, were over the age of 18 and the design was a randomized controlled trial of a self-management programme. The outcome measures for this review were quality of life, self-management skills and self-efficacy. The Behaviour Change Technique Taxonomy was used to code interventions for underlying components and alongside other intervention characteristics, associations with improvements in outcomes were explored.

Results

The search identified 3141 articles, 16 of which were eligible. A meta-analysis of self-efficacy scores from five studies (N = 536) found an improvement in those that received the self-management intervention at follow-up with a 12-point mean difference compared with the usual care group. Effects on quality of life and self-management skills were mixed, and meta-analyses of these data were not possible. Across 13 studies an average of 10 behaviour change techniques were used with, credible source (e.g. nurse, doctor, therapist) (n = 13), instruction on how to perform the behaviour (n = 13), demonstration of the behaviour (n = 12) used most often. The behaviour change technique of self-monitoring was associated with an improvement in quality of life. The involvement of a nurse was associated with higher self-efficacy and self-management skills.

Conclusion

This review suggests that self-management interventions can increase peoples’ self-efficacy for managing their stoma.

Impact

A standardized approach to the reporting of interventions and the measures used is needed in future studies to better understand the effect on quality of life and self-management skills.

摘要翻譯（僅供參考）

宗旨

探索來自隨機對照試驗的關(guān)于自我管理干預(yù)對生活質(zhì)量、自我管理技能和自我效能的影響的證據(jù)，并探索哪些干預(yù)特征與有效性相關(guān)。

設(shè)計

系統(tǒng)審查。

數(shù)據(jù)源

從 2000 年 1 月到 2020 年 2 月，在以下數(shù)據(jù)庫中檢索了文獻(xiàn)：MEDLINE (OVID)、EMBASE (OVID) 和 PsychINFO (OVID)。

復(fù)習(xí)方法

如果參與者有腸造口，年齡超過 18 歲，并且設(shè)計是一項自我管理計劃的隨機對照試驗，則研究被納入。本次審查的結(jié)果指標(biāo)是生活質(zhì)量、自我管理技能和自我效能。行為改變技術(shù)分類法用于對潛在組成部分的干預(yù)進(jìn)行編碼，并與其他干預(yù)特征一起，探索與結(jié)果改善的關(guān)聯(lián)。

結(jié)果

搜索確定了 3141 篇文章，其中 16 篇符合條件。對來自五項研究 ( N = 536)的自我效能評分的薈萃分析發(fā)現(xiàn)，與常規(guī)護(hù)理組相比，接受自我管理干預(yù)的患者在隨訪中有 12 點的平均差異。對生活質(zhì)量和自我管理技能的影響是混合的，無法對這些數(shù)據(jù)進(jìn)行薈萃分析。在 13 項研究中，平均使用了 10 種行為改變技術(shù)，包括可靠來源（例如護(hù)士、醫(yī)生、治療師）（n = 13）、如何執(zhí)行行為的指導(dǎo)（n = 13）、行為示范（n = 12) 最常用。自我監(jiān)測的行為改變技術(shù)與生活質(zhì)量的提高有關(guān)。護(hù)士的參與與更高的自我效能和自我管理技能有關(guān)。