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.

摘要翻译（仅供参考）

宗旨

探索来自随机对照试验的关于自我管理干预对生活质量、自我管理技能和自我效能的影响的证据，并探索哪些干预特征与有效性相关。

设计

系统审查。

数据源

从 2000 年 1 月到 2020 年 2 月，在以下数据库中检索了文献：MEDLINE (OVID)、EMBASE (OVID) 和 PsychINFO (OVID)。

复习方法

如果参与者有肠造口，年龄超过 18 岁，并且设计是一项自我管理计划的随机对照试验，则研究被纳入。本次审查的结果指标是生活质量、自我管理技能和自我效能。行为改变技术分类法用于对潜在组成部分的干预进行编码，并与其他干预特征一起，探索与结果改善的关联。

结果

搜索确定了 3141 篇文章，其中 16 篇符合条件。对来自五项研究 ( N = 536)的自我效能评分的荟萃分析发现，与常规护理组相比，接受自我管理干预的患者在随访中有 12 点的平均差异。对生活质量和自我管理技能的影响是混合的，无法对这些数据进行荟萃分析。在 13 项研究中，平均使用了 10 种行为改变技术，包括可靠来源（例如护士、医生、治疗师）（n = 13）、如何执行行为的指导（n = 13）、行为示范（n = 12) 最常用。自我监测的行为改变技术与生活质量的提高有关。护士的参与与更高的自我效能和自我管理技能有关。