妊娠期糖尿病患者血糖自我管理教育及支持的最佳证据总结

doi:10.3761/j.issn.0254-1769.2023.11.005

摘要/Abstract

摘要：

目的检索并评价妊娠期糖尿病（gestational diabetes mellitus，GDM）患者血糖自我管理教育及支持的相关证据，并对最佳证据进行汇总，为临床实践提供可靠的依据。方法按照“6S”证据模型自上而下的原则，系统检索计算机决策支持系统、指南网站、专业学会网站和数据库中关于GDM患者血糖自我管理教育及支持的相关证据，包括指南、专家共识、证据总结、最佳实践、临床决策和系统评价，检索时限为建库至2022年9月25日。2名研究人员选取符合纳入标准的文献，对文献质量进行评价，结合专业判断提取证据。结果共纳入16篇文献，包括指南6篇、专家共识1篇、证据总结4篇和系统评价5篇。从目标和原则、评估、自我管理教育和自我管理支持4个方面，总结了18条最佳证据。结论该研究总结了GDM患者血糖自我管理教育及支持的最佳证据，并形成了具体的建议，为护理人员指导GDM患者采取有效的个体化血糖自我管理方法提供了循证依据。

关键词: 妊娠期糖尿病, 血糖, 自我管理, 最佳证据, 循证护理学

Abstract:

Objective To retrieve and evaluate the available evidence on glycemic self-management education and support for patients with gestational diabetes mellitus，and to summarize the best evidence to provide references for clinical practice. Methods According to the top-down principle of the evidence-based resource 6S model，computer decision support systems，guideline websites，association official websites and databases were systematically searched for the relevant evidence on the glycemic self-management education and support for patients with gestational diabetes mellitus，including guidelines，expert consensuses，evidence summaries，best practice and systematic reviews. The search time limit was from the establishment of databases to September 25th 2022. 2 researchers evaluated the quality of the literature，extracted and summarized the evidence according to the subject. Results A total of 16 articles were included，including 6 guidelines，1 expert consensus，4 evidence summaries and 5 systematic reviews. 18 pieces of best evidence were summarized from 4 aspects，including the goals and principles of glycemic self-management，assessment，self-management education and self-management support. Conclusion This study summarized the best evidence of glycemic self-management education and support for patients with gestational diabetes mellitus and formed specific recommendations. The best evidence summarized in this study is meaningful for nurses providing evidence to establish individualized glycemic self-management programs for patients with gestational diabetes mellitus.

Key words: Gestational Diabetes Mellitus, Glucose, Self-Management, Best Evidence, Evidence-Based Nursing

查慧贤, 蒋英, 蒋玲, 严红云, 刘扣英, 于漫驰, 田星月, 陶梦琪, 刘晓兰. 妊娠期糖尿病患者血糖自我管理教育及支持的最佳证据总结[J]. 中华护理杂志, 2023, 58(11): 1308-1314.

ZHA Huixian, JIANG Ying, JIANG Ling, YAN Hongyun, LIU Kouying, YU Manchi, TIAN Xingyue, TAO Mengqi, LIU Xiaolan. Best evidence summary on glycemic self-management education and support for patients with gestational diabetes mellitus[J]. Chinese Journal of Nursing, 2023, 58(11): 1308-1314.

图/表 4

图1 PubMed的检索策略

Figure 1 Searching strategies of PubMed database

表1 纳入文献的基本特征（n=16）

Table 1 Characteristics of included studies（n=16）

表2 指南的方法学质量评价结果（n=6）

Table 2 Quality evaluation of guidelines（n=6）

表3 妊娠期糖尿病患者血糖自我管理教育及支持的最佳证据

Table 3 Best evidence summary on glycemic self-management education and support for patients with gestational diabetes mellitus

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