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针对患有精神疾病、神经疾病或脑损伤患者的照顾者的基于互联网的干预措施:系统评价

Internet-Based Interventions for Carers of Individuals With Psychiatric Disorders, Neurological Disorders, or Brain Injuries: Systematic Review.

作者信息

Spencer Lucy, Potterton Rachel, Allen Karina, Musiat Peter, Schmidt Ulrike

机构信息

Section of Eating Disorders, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.

The Eating Disorders Service, Maudsley Hospital, South London & Maudsley National Health Service Foundation Trust, London, United Kingdom.

出版信息

J Med Internet Res. 2019 Jul 9;21(7):e10876. doi: 10.2196/10876.

Abstract

BACKGROUND

Nonprofessional carers who provide support to an individual with a psychiatric or neurological disorder will often themselves experience symptoms of stress, anxiety, or low mood, and they perceive that they receive little support. Internet-based interventions have previously been found to be effective in the prevention and treatment of a range of mental health difficulties in carers.

OBJECTIVE

This review seeks to establish the status of internet-based interventions for informal (nonprofessional) carers of people with psychiatric or neurological disorders by investigating (1) the number and quality of studies evaluating the efficacy or effectiveness of internet-based carer interventions and (2) the impact that such interventions have on carer mental health, as well as (3) how internet-based interventions compare with other intervention types (eg, face-to-face treatment).

METHODS

A systematic literature search was conducted in January 2019 using the EMBASE (1974-present), Ovid MEDLINE (1946-present), PsychARTICLES, PsychINFO (1806-present), and Global Health (1973-present) databases, via the Ovid Technologies database. Search terms included carer, caregiver, online, technology, internet-based, internet, interactive, intervention, and evaluation. Studies selected for inclusion in this review met the following predetermined criteria: (1) delivering an intervention aimed primarily at informal carers, (2) carers supporting individuals with psychiatric disorders, stroke, dementia, or brain injury, (3) the intervention delivered to the carers was primarily internet based, (4) the study reported a pre- and postquantitative measure of carer depression, anxiety, stress, burden, or quality of life, (5) appeared in a peer-reviewed journal, and (6) was accessible in English.

RESULTS

A total of 46 studies were identified for inclusion through the detailed search strategy. The search was conducted, and data were extracted independently by 2 researchers. The majority of studies reported that 1 or more measures relating to carer mental health improved following receipt of a relevant intervention, with interventions for carers of people with traumatic brain injury showing a consistent link with improved outcomes.

CONCLUSIONS

Studies investigating internet-based interventions for carers of individuals with diverse psychiatric or neurological difficulties show some evidence in support of the effectiveness of these interventions. In addition, such interventions are acceptable to carers. Available evidence is of varying quality, and more high-quality trials are needed. Further research should also establish how specific intervention components, such as structure or interactivity, contribute to their overall efficacy with regard to carer mental health.

摘要

背景

为患有精神或神经疾病的个体提供支持的非专业护理人员自身往往会出现压力、焦虑或情绪低落的症状,且他们觉得自己得到的支持很少。此前已发现基于互联网的干预措施在预防和治疗护理人员的一系列心理健康问题方面有效。

目的

本综述旨在通过调查以下内容来确定针对患有精神或神经疾病患者的非正式(非专业)护理人员的基于互联网的干预措施的现状:(1)评估基于互联网的护理人员干预措施有效性的研究数量和质量;(2)此类干预措施对护理人员心理健康的影响;以及(3)基于互联网的干预措施与其他干预类型(如面对面治疗)相比如何。

方法

2019年1月通过Ovid Technologies数据库,在EMBASE(1974年至今)、Ovid MEDLINE(1946年至今)、PsychARTICLES、PsychINFO(1806年至今)和Global Health(1973年至今)数据库中进行了系统的文献检索。检索词包括护理人员、照顾者、在线、技术、基于互联网、互联网、交互式、干预和评估。入选本综述的研究符合以下预定标准:(1)提供主要针对非正式护理人员的干预措施;(2)护理人员为患有精神疾病、中风、痴呆或脑损伤的个体提供支持;(3)提供给护理人员的干预措施主要基于互联网;(4)研究报告了护理人员抑郁、焦虑、压力、负担或生活质量的定量前后测量结果;(5)发表在同行评审期刊上;(6)可获取英文版本。

结果

通过详细的检索策略共确定了46项研究纳入。检索由2名研究人员独立进行并提取数据。大多数研究报告称,在接受相关干预后,与护理人员心理健康相关的1项或多项指标有所改善,针对创伤性脑损伤患者护理人员的干预措施与改善的结果显示出一致的关联。

结论

针对患有各种精神或神经疾病个体的护理人员的基于互联网的干预措施的研究显示出一些证据支持这些干预措施的有效性。此外,此类干预措施为护理人员所接受。现有证据质量参差不齐,需要更多高质量的试验。进一步的研究还应确定特定的干预组成部分,如结构或交互性,如何在护理人员心理健康方面对其整体疗效做出贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7178/6647754/b45e812ac39d/jmir_v21i7e10876_fig1.jpg

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