Barlow J H, Ellard D R
Interdisciplinary Research Centre in Health, School of Health and Social Sciences, Coventry University, Coventry, UK.
Child Care Health Dev. 2004 Nov;30(6):637-45. doi: 10.1111/j.1365-2214.2004.00474.x.
The role of psycho-educational interventions in facilitating adaptation to chronic disease has received growing recognition and is in keeping with policy developments advocating greater involvement of patients in their own care. The purpose of this paper is to provide an overview of the current literature regarding the effectiveness of psycho-educational interventions for children and adolescents with chronic disease, their parents and siblings.
Electronic searches were conducted using AMED, CINAHL, Cochrane Database, DARE, HTA, MEDLINE, NHS EED, PsycLIT, PsycINFO, and PubMED. Inclusion criteria were systematic reviews, meta-analyses and overviews based on traditional reviews of published literature. The titles of papers were reviewed, abstracts were obtained and reviewed, and full copies of selected papers were obtained.
No reviews of psycho-educational interventions were found for either parents or siblings. Twelve reviews of interventions for children and adolescents were identified: chronic disease in general (three); chronic pain (one); asthma (three); chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) (one); diabetes (two); juvenile idiopathic arthritis (JIA) (one) and one informational intervention for paediatric cancer patients. The main focus was on disease management (particularly in asthma and diabetes) with less attention being paid to psychosocial aspects of life with a chronic condition. Overall, there is evidence of effectiveness for interventions incorporating cognitive-behavioural techniques on variables such as self-efficacy, self-management of disease, family functioning, psychosocial well-being, reduced isolation, social competence, knowledge, hope, pain (for chronic headache), lung function (asthma), days absent from school (asthma), visits to A & E (asthma), fatigue (CFS), and metabolic control (diabetes). A number of gaps and limitations were identified across all disease categories, such as inadequate description of interventions, small sample sizes, and lack of evidence regarding cost-effectiveness.
This overview has highlighted the need to extend the evidence base for psycho-educational interventions, particularly in a UK context. It is essential that effective interventions are implemented and embedded in service provision in order to maximize empowerment through self-care for children, adolescents and their parents.
心理教育干预在促进慢性病适应方面的作用日益受到认可，这与倡导患者更多参与自身护理的政策发展相一致。本文旨在概述当前有关针对患有慢性病的儿童、青少年及其父母和兄弟姐妹的心理教育干预效果的文献。
使用AMED、CINAHL、Cochrane数据库、DARE、HTA、MEDLINE、NHS EED、PsycLIT、PsycINFO和PubMED进行电子检索。纳入标准是基于对已发表文献的传统综述的系统评价、荟萃分析和概述。对论文标题进行了审查，获取并审查了摘要，并获取了选定论文的全文。
未找到针对父母或兄弟姐妹的心理教育干预的综述。确定了12篇针对儿童和青少年的干预综述：一般慢性病（3篇）；慢性疼痛（1篇）；哮喘（3篇）；慢性疲劳综合征（CFS）/肌痛性脑脊髓炎（ME）（1篇）；糖尿病（2篇）；青少年特发性关节炎（JIA）（1篇）以及一项针对儿科癌症患者的信息干预。主要重点是疾病管理（尤其是在哮喘和糖尿病方面），而对慢性病患者生活的心理社会方面关注较少。总体而言，有证据表明，采用认知行为技术的干预措施在诸如自我效能、疾病自我管理、家庭功能、心理社会幸福感、减少孤独感、社交能力、知识、希望、疼痛（针对慢性头痛）、肺功能（哮喘）、缺课天数（哮喘）、急诊就诊次数（哮喘）、疲劳（CFS）和代谢控制（糖尿病）等变量上是有效的。在所有疾病类别中都发现了一些差距和局限性，例如干预措施描述不足、样本量小以及缺乏成本效益证据。
本综述强调了扩展心理教育干预证据基础的必要性，特别是在英国背景下。实施有效的干预措施并将其纳入服务提供至关重要，以便通过儿童、青少年及其父母的自我护理实现最大程度的赋权。
