Klainin-Yobas Piyanee, Ng Shu Huey, Stephen Pricilia Dew Maria, Lau Ying
Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore.
National University Hospital, Singapore.
Patient Educ Couns. 2016 Apr;99(4):512-521. doi: 10.1016/j.pec.2015.10.020. Epub 2015 Nov 10.
This systematic review aimed to examine empirical evidence concerning the efficacy of psychosocial interventions in ameliorating the psychosocial problems of people with cardiovascular diseases (CVDs).
A comprehensive literature search was undertaken to identify both published and non-published English randomised controlled trials (RCTs) from 2000 to 2015. Two reviewers independently screened, assessed risks for bias, and extracted data. Comprehensive meta-analysis software was used to analyse the extracted data. Hedges's g effect size was used to determine the effects of psychosocial interventions.
Thirty studies were included in the review but only 18 studies reported significant short-term effects of psychosocial interventions in CVD patients. Most studies did not report long-term effects. Average effect sizes for stress, anxiety, depression, and combined depression/anxiety were 0.34, 1.04, 0.42 and 0.67 respectively at post-tests. Those numbers became 0.09, 0.65, 0.22 and 0.09 at follow-up assessments. Psychosocial programmes with psychoeducation and stress management helped reduce patients' stress and anxiety levels. Programmes including psychotherapy, counselling, mindfulness-based intervention (MBI), and stress management helped mitigate depression and anxiety.
The findings support the efficacy of some psychosocial interventions in people with CVDs.
Healthcare providers should monitor patients' psychological problems and may integrate psychosocial interventions as part of treatment plans.
本系统评价旨在检验有关心理社会干预改善心血管疾病（CVD）患者心理社会问题疗效的实证证据。
进行全面的文献检索，以识别2000年至2015年已发表和未发表的英文随机对照试验（RCT）。两名评价者独立筛选、评估偏倚风险并提取数据。使用综合荟萃分析软件分析提取的数据。采用Hedges's g效应量来确定心理社会干预的效果。
该评价纳入了30项研究，但只有18项研究报告了心理社会干预对CVD患者有显著短期效果。大多数研究未报告长期效果。在测试后，压力、焦虑、抑郁以及抑郁/焦虑合并症的平均效应量分别为0.34、1.04、0.42和0.67。在随访评估时，这些数字变为0.09、0.65、0.22和0.09。包含心理教育和压力管理的心理社会项目有助于降低患者的压力和焦虑水平。包括心理治疗、咨询、基于正念的干预（MBI）和压力管理的项目有助于减轻抑郁和焦虑。
研究结果支持某些心理社会干预对CVD患者的疗效。
医疗保健提供者应监测患者的心理问题，并可将心理社会干预纳入治疗计划的一部分。
