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

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.