超重或肥胖患者饮食或运动干预依从性促进和阻碍因素的Meta整合

doi:10.3761/j.issn.0254-1769.2024.18.013

摘要/Abstract

摘要：

目的系统评价和整合超重或肥胖患者饮食或运动干预依从性的促进和阻碍因素。方法计算机检索PubMed、Web of Science、Embase、CINAHL、Cochrane Library、中国知网、万方数据库、维普数据库及中国生物医学文献数据库，检索时限为建库至2023年10月14日。采用2016年版澳大利亚乔安娜布里格斯研究所循证卫生保健中心质性研究评价标准对纳入文献进行评价和整合。结果共纳入19篇文献，提炼出38个结果，归纳为12个类别，并将结果整合为超重或肥胖患者饮食或运动干预依从性的促进因素（疾病威胁感知、自我体型感知、自我调适、责任感知、社会支持）和超重或肥胖患者饮食或运动干预依从性阻碍因素（治疗获益感差、自我效能低下、知识缺乏、竞争性优先事项、外部环境限制、经济条件限制、干预设计欠佳）。结论超重或肥胖患者感知到的饮食或运动干预的促进和阻碍因素较多，建议后续干预研究以此为参考依据，提高患者的治疗依从性。

关键词: 超重, 肥胖, 依从性, 质性研究, Meta整合, 循证护理学

Abstract:

Objective To evaluate and integrate the facilitators and barriers to adherence to diet or exercise interventions in patients with overweight or obesity. Methods PubMed，Web of Science，Embase，CINAHL，Cochrane Library，China National Knowledge Infrastructure，Wanfang，and VIP Chinese Biomedical Literature Database were searched by computer from the establishment of the database to October 14，2023. The 2016 edition of the Joanna Briggs Institute（JBI） evidence-based health care center qualitative research evaluation criteria was used to evaluate and integrate the included literature. Results A total of 19 studies were included，and 38 outcomes were distilled into 12 categories，and the results were consolidated into facilitators（disease threat perception，self-body perception，self-adjustment，sense of responsibility，social support） and barriers to intervention adherence（poor treatment benefit，low self-efficacy，lack of knowledge，competitive priorities，external environmental constraints，economic conditions，poor intervention design）. Conclusion There are many facilitators and barriers of diet or exercise intervention perceived by patients. It is suggested that follow-up intervention research should be used as a reference to improve the treatment compliance of patients.

Key words: Overweight, Obesity, Compliance, Qualitative Research, Meta-Synthesis, Evidence-Based Nursing

苟晓瑜, 李梦洁, 卢楠, 于万慧, 迟嘉婧, 杨丽娟. 超重或肥胖患者饮食或运动干预依从性促进和阻碍因素的Meta整合[J]. 中华护理杂志, 2024, 59(18): 2269-2276.

GOU Xiaoyu, LI Mengjie, LU Nan, YU Wanhui, CHI Jiajing, YANG Lijuan. Facilitators and barriers to adherence to diet or exercise interventions in patients with overweight or obesity：a Meta-synthesis[J]. Chinese Journal of Nursing, 2024, 59(18): 2269-2276.

图/表 4

图1 PubMed检索策略

Figure 1 PubMed search strategies

图2 文献筛选流程

Figure 2 Literature screening process

表1 纳入文献基本特征（n=19）

Table 1 Characteristics of included studies（n=19）

表2 纳入文献的方法学质量评价（n=19）

Table 2 Methodological quality appraisal of included literatures（n=19）

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