| 摘要: | 目的：智慧型手機介入對第一型糖尿病患者血糖控制及生活品質之改善成效
方法：本研究採用系統性文獻回顧與統合分析，搜尋電子資料庫包含：PubMed, EMBASE, CINAHL, Cochrane Library, and ProQuest, Chinese Electronic Periodical Services, China Knowledge Resource Integrated等七個資料庫，使用關鍵字為第一型糖尿病、智慧型手機、生活品質、血糖控制，且限定為隨機對照試驗（Randomized Controlled Trial, RCT）之文獻，使用考克蘭誤差風險評估工具1.0進行文獻品質評量，並採用Comprehensive Meta-Analysis 2.0統計軟體進行資料輸入與分析
，以固定效果或隨機效果模式進行整體效果量估計，針對異質性分析將採用Cochran's Q值和 I2值進行檢定，並使用Egger's test檢定法、Begg's test檢定法及刪除填補法（Trim and fill）檢定出版偏差。
結果：研究結果共納入11篇文獻，針對智慧型手機介入對於第一型糖尿病血糖控制具有改善成效，固定效果模式顯示整體平均效果量為-0.17（95%CI= -.31 ~ -.03，p= .017）；針對智慧型手機介入對於第一型糖尿病生活品質亦具有改善成效，固定效果模式顯示整體平均效果量為0.34（95%CI = .19 ~ .49，p< .001），Cochran's Q值和 I2值結果皆顯示納入文章無顯著異質性；Egger's test檢定法、Begg's test檢定法及刪除填補法（Trim and fill）檢定結果顯示無出版偏差。
結論：智慧型手機介入後對第一型糖尿病患者提升血糖控制具輕微改善成效，顯示運用智慧型手機即時監測回饋應用程式對第一型糖尿病患者血糖控制之實務運用仍須謹慎考量。
Title of Thesis: The effects of smartphone interventions on improving blood sugar control and quality of life in patients with type 1 diabetes: A meta-analysis
Institution: Master Program in School of Nursing, Taipei Medical University
Author: Chin-Jung Liu
Thesis directed by: Hui-Chuan Huang Assistant Professor
Objective: The Meta-analysis aimed to examine the effect of smartphone interventions on improving blood sugar control and quality of life in patients with type 1 diabetes.
Methods: Various datasets including PubMed, EMBASE, CINAHL, Cochrane Library, and ProQuest, Chinese Electronic Periodical Services, and China Knowledge Resource Integrated database were searched for recruiting relevant studies with randomized controlled trials (RCT). The quality of the included articles was evaluated using Cochrane Collaboration’s tool 1.0. Comprehensive Meta-Analysis 2.0 statistical software was used to perform data entry and data analysis. A fixed effect model or random effect model was used to examine the overall effect of smartphone use on improving blood sugar control and quality of life. Cochran 'Q test and I2 test were performed to assess the heterogeneity among the included studies. Various methods comprising Egger’s test, Begg’s test, and trim and fill were adopted to examine publication bias.
Results: In total, 11 RCTs were recruited in the study. Results of fixed effects model showed that the use of smartphone significant benefited blood sugar control (MD= -0.17, 95%CI = -.31 ~ -.03，p=0.017). Moreover, the use of smartphone interventions can improve quality of life (SMD= 0.34, 95%CI = .19~.49，p < .001) in patients with type 1 diabetes. Both Cochran 'Q test and I2 test indicated no heterogeneity among these included studies. Besides, no publication bias was confirmed by insignificant Egger’s test and Begg’s test. Moreover, results of trim and fill showed the use of smartphone had significant improvements of blood sugar control and quality of life of patients with Type 1 diabetes after adding appropriate missing articles.
Conclusion: The meta-analysis recruiting 11 RCT confirmed that smartphone interventions have mild improvements of blood sugar control in patients with type 1 diabetes. Applying smartphone interventions on improving of blood sugar control in patients with type 1 diabetes should be use of caution. |
