* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *。S %A Zagora,Justin %+数字健康与健康中心，健康教育与行为系，佛罗里达大学，邮箱118210,FLG 8, Gainesville, FL, 32611，美国，1 352 294 1805,mstellefson@ufl.edu %K慢性疾病%K自我护理%K互联网%K社交媒体%D 2013 %7 14.02.2013 %9原创论文%J J医学互联网Res %G英文%X背景:参与式Web 2.0干预促进协作，支持慢性疾病自我管理。Web 2.0干预措施的增长导致了电子患者通信工具的出现，使老年人能够(1)定位和共享疾病管理信息，(2)接受交互式医疗保健建议。老年电子患者的发展为Web 2.0健康和医疗论坛做出了贡献，为实现更好的慢性疾病结果带来了更大的机会。到目前为止，还没有针对老年人的Web 2.0慢性疾病自我管理干预措施的规划、实施和评估的综述文章。目的:回顾Web 2.0自我管理干预对患有一种或多种慢性疾病的老年人(平均年龄≥50岁)的规划、实施和总体有效性。方法:利用6个流行健康科学数据库进行系统文献检索。采用RE-AIM (Reach, Efficacy, Adoption, Implementation and Maintenance)模型对15篇综述文章的研究结果进行组织，并计算研究质量评分(SQS)。结果:大多数干预措施由多学科医疗保健团队采用，并在患有糖尿病的白人女性小样本中进行测试。研究表明，Web 2.0参与者在管理他们的疾病时感到更强的自我效能感，并从与医疗保健提供者和/或网站管理员的交流中受益，以获得反馈和社会支持。 Participants noted asynchronous communication tools (eg, email, discussion boards) and progress tracking features (eg, graphical displays of uploaded personal data) as being particularly useful for self-management support. Despite high attrition being noted as problematic, this review suggests that greater Web 2.0 engagement may be associated with improvements in health behaviors (eg, physical activity) and health status (eg, HRQoL). However, few studies indicated statistically significant improvements in medication adherence, biological outcomes, or health care utilization. Mean SQS scores were notably low (mean=63%, SD 18%). Studies were judged to be weakest on the Maintenance dimension of RE-AIM; 13 reviewed studies (87%) did not describe any measures taken to sustain Web 2.0 effects past designated study time periods. Detailed process and impact evaluation frameworks were also missing in almost half (n=7) of the reviewed interventions. Conclusions: There is need for a greater understanding of the costs and benefits associated with using patient-centered Web 2.0 technologies for chronic disease self-management. More research is needed to determine whether the long-term effectiveness of these programs is sustainable among larger, more diverse samples of chronically ill patients. The effective translation of new knowledge, social technologies, and engagement techniques will likely result in novel approaches for empowering, engaging, and educating older adults with chronic disease. %M 23410671 %R 10.2196/jmir.2439 %U //www.mybigtv.com/2013/2/e35/ %U https://doi.org/10.2196/jmir.2439 %U http://www.ncbi.nlm.nih.gov/pubmed/23410671

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