Riddle J P, Smith H E, Jones C J
Division of Primary Care and Public Health, Brighton and Sussex Medical School, BN1 9PH, UK.
Division of Primary Care and Public Health, Brighton and Sussex Medical School, BN1 9PH, UK.
Behav Res Ther. 2016 May;80:23-32. doi: 10.1016/j.brat.2016.03.004. Epub 2016 Mar 19.
There are 5.8 million caregivers providing support to the infirm, disabled or elderly in the United Kingdom. Caregivers experience adverse physical and mental health outcomes and increased mortality. Low cost, effective interventions are needed to increase the wellbeing of caregivers. Written emotional disclosure (WED) has been shown to improve health in a range of populations. This systematic review and meta-analysis aimed to establish whether WED improves the psychological and physical health of caregivers. Searches were conducted in Medline, EMBASE, CINAHL, BNI, PsycINFO, Cochrane Library from 1986 to 2015. Ten trials investigating WED (625 participants) met the inclusion criteria. Results from four studies (n = 118) indicated that WED reduces trauma (SMD = -0.46, 95% CI -0.82, -0.09). Data from three studies (n = 102) suggest that WED improves general psychological health (SMD = -0.46, 95% CI -0.86, -0.06). There was no evidence that WED improves depression, anxiety, physical symptoms, quality of life or burden. Observations suggest WED may be more effective for caregivers of less than 5 years. Studies were highly heterogeneous in regards to caregiver age, relationship to care recipient, impairment of care recipient, follow up period and outcome measures, with high or unclear bias often observed. More rigorous RCTs, with clearly described interventions and standardised outcome measures, are needed to confirm these findings.
在英国，有580万护理人员为体弱者、残疾人或老年人提供支持。护理人员身心健康状况不佳，死亡率也有所上升。需要低成本、有效的干预措施来提高护理人员的幸福感。书面情感披露（WED）已被证明能改善一系列人群的健康状况。本系统评价和荟萃分析旨在确定书面情感披露是否能改善护理人员的心理和身体健康。检索了1986年至2015年期间的Medline、EMBASE、CINAHL、BNI、PsycINFO、Cochrane图书馆。十项调查书面情感披露的试验（625名参与者）符合纳入标准。四项研究（n = 118）的结果表明，书面情感披露可减轻创伤（标准化均数差= -0.46，95%可信区间-0.82，-0.09）。三项研究（n = 102）的数据表明，书面情感披露可改善总体心理健康（标准化均数差= -0.46，95%可信区间-0.86，-0.06）。没有证据表明书面情感披露能改善抑郁、焦虑、身体症状、生活质量或负担。观察结果表明，书面情感披露对护理年限不足5年的护理人员可能更有效。在护理人员年龄、与受护理者的关系、受护理者的损伤情况、随访期和结局指标方面，研究存在高度异质性，经常观察到高偏倚或不明确的偏倚。需要更严格的随机对照试验，采用清晰描述的干预措施和标准化的结局指标，以证实这些发现。
