Institute of Psychology Health & Society, Department of Health Services Research, University of Liverpool, Room 1.88, Eleanor Rathbone Building, 74 Bedford Street South, Liverpool, L69 7ZQ, UK; Department of Psychology, University of Cape Town, Rondebosch, 7701, South Africa.
Liverpool Reviews & Implementation Group, University of Liverpool, UK.
Behav Res Ther. 2015 Oct;73:151-64. doi: 10.1016/j.brat.2015.08.004. Epub 2015 Aug 14.
Cardiac surgery patients may be provided with psychological interventions to counteract depression and anxiety associated with surgical procedures. This systematic review and meta-analysis investigated whether intervention efficacy was impacted by type of cardiac procedure/cardiac event; control condition content; intervention duration; intervention timing; facilitator type; and risk of bias. MEDLINE, EMBASE, and PsycINFO were searched for randomized controlled trials comparing anxiety and depression outcomes, pre and post psychological and cardiac interventions. Twenty-four studies met the inclusion criteria for the systematic review (N = 2718) and 16 of those were meta-analysed (N = 1928). Depression and anxiety outcomes were reduced more in interventions that lasted longer, were delivered post-surgery, and by trained health professionals. Depression (but not anxiety) was reduced more when the experimental intervention was compared to an 'alternative' intervention, and when the intervention was delivered to coronary artery bypass graft patients. Anxiety (but not depression) was decreased more when interventions were delivered to implantable cardioverter defibrillator patients, and were of 'high' or 'unclear' risk of bias. In addition to estimating efficacy, future work in this domain needs to take into account the moderating effects of intervention, sample, and study characteristics.
心脏手术患者可能会接受心理干预，以对抗与手术相关的抑郁和焦虑。本系统评价和荟萃分析调查了干预效果是否受到心脏手术/心脏事件类型、对照条件内容、干预持续时间、干预时机、促进者类型和偏倚风险的影响。对 MEDLINE、EMBASE 和 PsycINFO 进行了检索，以比较焦虑和抑郁的结果，比较心理和心脏干预的前后。24 项研究符合系统评价的纳入标准（N = 2718），其中 16 项进行了荟萃分析（N = 1928）。持续时间较长、手术后进行以及由训练有素的卫生专业人员进行的干预，可更有效地降低抑郁和焦虑的发生。与“替代”干预相比，实验组干预可降低抑郁（而非焦虑），而当干预用于冠状动脉旁路移植术患者时，也可降低抑郁。与植入式心脏复律除颤器患者相比，焦虑（而非抑郁）可通过干预降低，而干预具有“高”或“不明确”的偏倚风险。除了评估疗效外，该领域的未来工作还需要考虑干预、样本和研究特征的调节作用。
