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认知行为疗法对重症患儿家属心理健康影响的系统评价和meta分析

The effect of cognitive-behavioral therapy on caregivers' mental health of critically ill children: a systematic review and meta-analysis

    摘要
  • 摘要:
    目的 评价认知行为疗法对重症患儿家属心理健康状况的干预效果。
    方法 通过计算机检索从建库至2020年12月PubMed、PsychINFO、Embase、Web of Science、the Cochrane Library、CINAHL Complete、中国生物医学文献数据库、中国知网、万方数据库和维普中文期刊数据库中有关认知行为疗法对重症患儿家属应用效果评价的临床对照研究, 使用RevMan 5.3统计软件进行meta分析。
    结果 共纳入9项研究进行meta分析, 结果显示, 认知行为疗法可缓解重症患儿家属创伤后应激状况SMD = －0.34(95% CI: －0.59 ~－0.08), Z = 2.59, P = 0.01和焦虑状况SMD =－0.36(95% CI: －0.55 ~－0.18), Z = 3.89, P < 0.001, 但对缓解抑郁状况差异无统计学意义SMD =－0.33(95% CI: －0.89 ~ 0.24), Z = 1.12, P = 0.26。
    结论 认知行为疗法可以缓解重症患儿家属创伤后应激和焦虑状况, 但对改善其抑郁状况效果不明显。受限于目前纳入研究的方法、研究数量和研究质量的影响, 尚需开展更多高质量、大样本和多中心的临床随机对照试验, 以进一步探索和评价其应用成效, 增加证据强度。

     

    Abstract:
    Objective To evaluate the effect of cognitive-behavioral therapy on caregivers' mental health of critically ill children.
    Methods A systematic search for literature of clinical controlled trials of the effect of cognitive-behavioral therapy on caregivers' mental health of critically ill children was conducted through PubMed, PsychINFO, Embase, Web of Science, the Cochrane Library, CINAHL Complete, Chinese Biomedical Literature Database, CNKI, Wanfang Database, and Weipu Chinese Journal Database from the establishment of these databases to December 2020. RevMan 5.3 statistical software was used for meta analysis.
    Results Data from 9 studies were included in the meta analysis. The results showed that cognitive behavioral therapy could alleviate post-traumatic stress SMD =－0.34 (95% CI: －0.59-－0.08), Z = 2.59, P = 0.01 and anxiety SMD =－0.36 (95% CI: －0.55-－0.18), Z = 3.89, P < 0.001 of critically ill children's caregivers, but it had no significant effect on their depression level SMD =－0.33(95% CI: －0.89-0.24), Z = 1.12, P = 0.26.
    Conclusion Cognitive behavioral therapy can relieve post-traumatic stress and anxiety of critically ill children's caregivers, but it has no effect on alleviating their depression. Due to limitation of the methods, number and quality of the included studies, more high-quality, large-sample and multi-center clinical randomized controlled trials are needed to further explore and evaluate its effectiveness and strengthen the evidence.

     

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