Siette Joyce, Cassidy Megan, Priebe Stefan
Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
Unit of Social and Community Psychiatry, Barts and the London School of Medicine and Dentistry, University of London, London, UK.
BMJ Open. 2017 Apr 26;7(4):e014304. doi: 10.1136/bmjopen-2016-014304.
Befriending is an emotional supportive relationship in which one-to-one companionship is provided on a regular basis by a volunteer. It is commonly and increasingly offered by the voluntary sector for individuals with distressing physical and mental conditions. However, the effectiveness of this intervention on health outcomes is largely unknown. We aim to conduct a systematic review of the benefits of befriending.
Systematic review.
A systematic search of electronic databases was conducted to identify randomised controlled trials and quasi-experimental trials of befriending for a range of physical and mental health indications including depression, anxiety, mental illness, cancer, physical illness and dementia. Main outcomes included patient-relevant and disease-specific outcomes, such as depression, loneliness, quality of life, self-esteem, social support and well-being.
A total of 14 trials (2411 participants) were included; 7 were judged at low risk of bias. Most trials showed improvement in symptoms associated with befriending but these associations did not reach statistical significance in all trials. Befriending was significantly associated with better patient-reported outcomes across primary measures (standardised mean difference 0.18 (95% CI, -0.002 to 0.36, I=26%, seven trials)). However, there was no significant benefit on single outcomes, including depression, quality of life, loneliness ratings, self-esteem measures, social support structures and well-being.
There was moderate quality evidence to support the use of befriending for the treatment of individuals with different physical and mental health conditions. This evidence refers to an overall improvement benefit in patient-reported primary outcomes, although with a rather small effect size. The current evidence base does not allow for firm conclusions on more specific outcomes. Future trials should hypothesise a model for the precise effects of befriending and use specified inclusion and outcome criteria.
交友帮扶是一种情感支持关系，志愿者会定期提供一对一陪伴。志愿部门越来越普遍地为身心状况不佳的个人提供这种服务。然而，这种干预措施对健康结果的有效性在很大程度上尚不清楚。我们旨在对交友帮扶的益处进行系统评价。
系统评价。
对电子数据库进行系统检索，以识别针对一系列身心健康指征（包括抑郁症、焦虑症、精神疾病、癌症、身体疾病和痴呆症）开展的交友帮扶随机对照试验和准实验性试验。主要结局包括与患者相关及特定疾病的结局，如抑郁、孤独感、生活质量、自尊、社会支持和幸福感。
共纳入14项试验（2411名参与者）；7项被判定为低偏倚风险。大多数试验显示与交友帮扶相关的症状有所改善，但这些关联在所有试验中均未达到统计学显著性。在主要指标方面，交友帮扶与更好的患者报告结局显著相关（标准化均值差0.18（95%置信区间，-0.002至0.36，I²=26%，7项试验））。然而，在包括抑郁、生活质量、孤独感评分、自尊测量、社会支持结构和幸福感等单一结局方面，未发现显著益处。
有中等质量的证据支持将交友帮扶用于治疗不同身心健康状况的个体。该证据表明患者报告的主要结局有整体改善益处，尽管效应量相当小。目前的证据基础不允许就更具体的结局得出确凿结论。未来的试验应设想一个交友帮扶精确效果的模型，并使用特定的纳入标准和结局标准。
