a Department of Nursing , The Second Affiliated Hospital of Nantong University , Nantong , China.
b School of Nursing , Nantong University , Nantong , China.
Psychol Health Med. 2018 Jan;23(1):1-17. doi: 10.1080/13548506.2017.1282160. Epub 2017 Jan 31.
The aim of this study was to determine the effects of psychological interventions (e.g. cognitive restructuring, relaxation) on physiological and psychological health in osteoarthritis patients. A systematic literature search was done using PubMed, Embase, PsycINFO, Web of Science, China National Knowledge Infrastructure, and Wanfang Database through November 2016. Studies were included if they used a randomized controlled trial designed to explore the effects of psychological interventions in osteoarthritis patients. Two independent authors assessed the methodological quality of the trials using criteria outlined by Jadad et al. Meta-analysis was done with the Revman5.0. Twelve randomized controlled trials, including 1307 osteoarthritis patients, met the study inclusion criteria. Meta-analysis showed that psychological interventions could reduce the levels of pain [standard mean difference (SMD) -0.28, 95% CI -0.48, -0.08, P-value 0.005)] and fatigue (SMD -0.18, 95% CI -0.34, -0.01, P-value 0.04). In addition, psychological interventions significantly improved osteoarthritis patients' self-efficacy (SMD 0.58, 95% CI 0.40, 0.75, P-value 0.00) and pain coping (MD 1.64, 95% CI 0.03, 3.25, P-value 0.05). Although the effects on physical function, anxiety, depression, psychological disability were in the expected direction, they were not statistically significant. In conclusion, the role of psychological interventions in the management of osteoarthritis remains equivocal. Some encouraging results were seen with regard to pain, pain coping, self-efficacy, and fatigue. We believe that more methodologically rigorous large-scale randomized controlled trials are necessary to answer this study question.
本研究旨在确定心理干预（例如认知重构、放松）对骨关节炎患者生理和心理健康的影响。通过 2016 年 11 月在 PubMed、Embase、PsycINFO、Web of Science、中国国家知识基础设施和万方数据库进行系统文献检索，纳入使用随机对照试验设计来探索心理干预对骨关节炎患者影响的研究。两名独立作者使用 Jadad 等人提出的标准评估试验的方法学质量。采用 Revman5.0 进行荟萃分析。12 项随机对照试验，共纳入 1307 例骨关节炎患者，符合研究纳入标准。荟萃分析显示，心理干预可降低疼痛水平[标准均数差（SMD）-0.28，95%置信区间（CI）-0.48，-0.08，P 值 0.005]和疲劳（SMD-0.18，95%CI-0.34，-0.01，P 值 0.04）。此外，心理干预显著改善骨关节炎患者的自我效能感（SMD 0.58，95%CI 0.40，0.75，P 值 0.00）和疼痛应对（MD 1.64，95%CI 0.03，0.35，P 值 0.05）。虽然身体功能、焦虑、抑郁和心理残疾的影响符合预期，但无统计学意义。总之，心理干预在骨关节炎管理中的作用仍存在争议。在疼痛、疼痛应对、自我效能感和疲劳方面观察到一些令人鼓舞的结果。我们认为，需要进行更多方法学严谨的大规模随机对照试验来回答这个研究问题。
