School of Psychology, The University of Sydney.
Sydney Medical School, The University of Sydney.
Health Psychol. 2019 Feb;38(2):151-161. doi: 10.1037/hea0000704.
Guidelines recommend psychological intervention for children, adolescents, and adults with childhood-onset heart disease and their families, yet a comprehensive review of interventions is lacking. We aimed to determine the efficacy of psychological interventions for this population.
We searched 6 electronic databases until August, 2017 for English-language, controlled trials of psychological interventions for children, adolescents, or adults with congenital heart disease, inherited arrhythmias, or cardiomyopathies, or their family members. Outcomes of interest included: anxiety, depression, psychological stress and distress, health-related quality of life, coping and adjustment, developmental outcomes, physical health, and parent and family outcomes.
Of 7,660 identified articles, 11 articles reporting on 9 unique interventions met inclusion criteria. Four interventions included adolescents or adults with congenital heart disease, 2 of which also included individuals with cardiomyopathies, valvular heart conditions, or inherited arrhythmias. Five interventions targeted parents, predominantly mothers, of children with congenital heart disease. Clinical and methodological diversity was observed across trials. Parent-focused interventions demonstrated some improvements in maternal mental health, including anxiety and worry, coping, and family functioning. Evidence for the efficacy of interventions for adolescents and adults was limited. Most trials (8/9) were at "high" or "serious" risk of bias.
Despite an established evidence-base for psychological interventions in other chronic illness populations, evidence of efficacy for children and adults with childhood-onset heart disease and their families was limited. Interventions using conceptual frameworks tested in methodologically robust trials are needed to enhance the provision of mental health care for people of all ages with childhood-onset heart disease. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
指南建议对儿童、青少年和成年起病的先天性心脏病患者及其家属进行心理干预，但目前缺乏对干预措施的全面评估。本研究旨在确定心理干预对该人群的疗效。
我们检索了 6 个电子数据库，检索时间截至 2017 年 8 月，收集了针对先天性心脏病、遗传性心律失常或心肌病儿童、青少年或成人及其家庭成员的心理干预的英语对照试验。我们感兴趣的结局指标包括：焦虑、抑郁、心理压力和痛苦、健康相关生活质量、应对和调整、发育结局、身体健康和父母及家庭结局。
在 7660 篇文章中，有 11 篇文章报告了 9 项不同的干预措施，符合纳入标准。其中 4 项干预措施纳入了先天性心脏病青少年或成年人，其中 2 项还纳入了心肌病、瓣膜性心脏病或遗传性心律失常患者。另外 5 项干预措施针对先天性心脏病儿童的父母，主要是母亲。试验之间存在临床和方法学的多样性。以父母为重点的干预措施显示出母亲心理健康（包括焦虑和担忧、应对方式和家庭功能）的一些改善。针对青少年和成年人的干预措施的疗效证据有限。大多数试验（8/9）的偏倚风险为“高”或“严重”。
尽管在其他慢性疾病患者中已经有了心理干预的明确证据基础，但针对儿童和成年起病的先天性心脏病患者及其家属的干预措施疗效有限。需要使用经过方法学上可靠试验检验的概念框架的干预措施，以加强对所有年龄段儿童起病的先天性心脏病患者的心理健康护理。（PsycINFO 数据库记录（c）2019 APA，保留所有权利）。
