Center for Psychosocial Medicine, Department of Psychosomatic and General Internal Medicine, University of Heidelberg, Heidelberg, Germany. mechthild.hartmann @ med.uni-heidelberg.de
Psychother Psychosom. 2010;79(3):136-48. doi: 10.1159/000286958. Epub 2010 Feb 20.
Families can have considerable influence on the health of a patient with a chronic physical disease, and attempts have been made to optimise treatment by involving family members. This meta-analysis aimed to systematically assess the effects of family-oriented interventions on adults with chronic physical diseases.
A systematic literature search was conducted to identify randomised clinical trials that have evaluated the effects of family-based interventions for adult patients compared to standard treatment. Interventions were classified as psychoeducation or addressing family relationships. The outcomes studied were the patient's physical and mental health and the health of the family members. The effect sizes were calculated as Hedges' g and combined using random-effects models.
Fifty-two relevant randomised controlled trials (including 8,896 patients) were extracted. The main disease groups were cardiovascular diseases including stroke, cancer and arthritis. Meta-analysis showed that family involvement resulted in significantly better health than standard treatment for all outcomes. The mean overall effect sizes were 0.32 for the patients' physical health, 0.28 for the patients' mental health and 0.35 for the family members' health. Overall, the effects were not large, but they were broad, significant and stable over a long period of time. There was a tendency towards higher effects in favour of relationship-focused family interventions compared to educational interventions.
Psychosocial interventions involving family members in the treatment of chronic physical diseases have positive effects on the health outcome for both the patient and his/her family. Further high-quality research is necessary to investigate differential effects.
家庭对患有慢性躯体疾病的患者的健康有很大影响，因此人们尝试通过让家庭成员参与来优化治疗效果。本荟萃分析旨在系统评估以家庭为导向的干预措施对患有慢性躯体疾病的成年人的影响。
系统检索了评估家庭为基础的干预措施与标准治疗相比对成年患者影响的随机临床试验。干预措施分为教育或处理家庭关系。研究的结果是患者的身心健康和家庭成员的健康。使用随机效应模型计算效应量作为 Hedges'g。
提取了 52 项相关的随机对照试验（包括 8896 名患者）。主要疾病组包括心血管疾病，包括中风、癌症和关节炎。荟萃分析显示，与标准治疗相比，家庭参与可显著改善所有结局的健康状况。患者身体健康的总体平均效应大小为 0.32，心理健康为 0.28，家庭成员健康为 0.35。总体而言，这些影响虽然不大，但广泛、显著且稳定，持续时间长。与教育干预相比，以关系为重点的家庭干预倾向于产生更高的效果。
在治疗慢性躯体疾病时，让家庭成员参与心理社会干预对患者及其家庭的健康结果有积极影响。需要进一步开展高质量的研究来探讨差异影响。
