%0期刊文章%@ 1438- 8871% I JMIR出版物%V 21卡塔尔世界杯8强波胆分析% N 11% P e12384 %T慢性肾脏疾病患者的电子健康自我管理干预措施:定量和定性证据系统综述%A Shen，洪夏%A van der Kleij,Rianne M J J %A van der Boog,Paul J M %A Chang,Xinwei %A Chavannes,Niels H %+莱顿大学医学中心公共卫生和初级保健系，Albinusdreef 2，莱顿，2333 ZA，荷兰，31 633789207,H.Shen@lumc.nl %K eHealth %K自我管理%K系统综述%K慢性肾脏疾病%D 2019 %7 5.11.2019 %9综述%J J Med Internet Res %G英文%X背景:慢性肾脏疾病(CKD)对公共卫生构成重大挑战。在CKD患者中，充分的疾病自我管理已被证明可以改善近端和远端结果。目前，电子健康(eHealth)干预措施越来越多地用于优化患者的自我管理技能。目的:本研究旨在系统回顾CKD患者电子健康自我管理干预措施的实施和有效性的现有证据。方法:检索8个数据库(截至2017年11月)，从相关研究中提取过程和效果结果的定量和定性数据。质量评价采用Crowe关键评价工具;对提取的数据进行叙事综合分析。结果:在检索到的3307篇文章中，24篇(包括23篇研究)被纳入本综述; of these, almost half were appraised to be of low to moderate quality. There was considerable heterogeneity in the types of interventions used and the outcomes measured. A total of 10 effect and 9 process outcome indicators were identified. The most frequently reported effect outcome indicators were specific laboratory tests and blood pressure (BP), whereas satisfaction was the most frequently reported process outcome indicator. Positive effects were found for proximal outcomes (eg, BP control and medication adherence), and mixed effects were found for more distal outcomes (eg, quality of life). High feasibility, usability, and acceptability of and satisfaction with eHealth self-management interventions were reported. The determinant ability of health care professionals to monitor and, if necessary, anticipate on patient measurements online was mostly cited to influence patients’ adherence to interventions. Conclusions: eHealth self-management interventions have the potential to improve disease management and health outcomes. To broaden the evidence base and facilitate intervention upscaling, more detailed descriptions and thorough analysis of the intervention components used are required. In addition, our review reveals that outcomes closely related to the scope and duration of the intervention implemented are most likely to be impacted. For instance, if a 4-week Web-based training to optimize disease management skills is implemented, the outcome perceived control would more likely be affected than kidney function. Although this seems obvious, most studies evaluate only distal outcomes and thereby fail to capture intervention effects that might contribute to long-term health improvement. We advise future researchers to carefully consider their choice of outcomes based on their sensitivity for change. In this way, we ensure that relevant effects are captured and legitimate conclusions are drawn. %M 31687937 %R 10.2196/12384 %U //www.mybigtv.com/2019/11/e12384 %U https://doi.org/10.2196/12384 %U http://www.ncbi.nlm.nih.gov/pubmed/31687937