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心理干预对减少儿童和青少年发育障碍父母的压力、抑郁和焦虑的作用:系统评价和荟萃分析。

Psychological interventions in reducing stress, depression and anxiety among parents of children and adolescents with developmental disabilities: A systematic review and meta-analysis.

机构信息

Nursing Division, KK Women's and Children's Hospital, Singapore, Singapore.

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 2, Clinical Research Centre, Singapore, Singapore.

出版信息

J Adv Nurs. 2019 Dec;75(12):3316-3330. doi: 10.1111/jan.14166. Epub 2019 Aug 27.

Abstract

AIMS

To evaluate the effectiveness of psychological interventions in reducing stress, depression and anxiety among parents of children and adolescents with developmental disabilities.

DESIGN

A systematic review and a meta-analysis.

DATA SOURCES

Seven electronic databases (CINAHL, CENTRAL, EMBASE, ProQuest Dissertation and Theses, PsycINFO, PubMed and Scopus) were searched from each database's point of inception to December 2018.

REVIEW METHODS

Quality appraisal was conducted using the Cochrane Risk of Bias Tool. Data were analysed using Review Manager 5.3. The overall quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation system.

RESULTS

A total of 18 studies were included in this review. Eleven studies were involved in a meta-analysis and the remaining seven studies were summarized narratively. The meta-analysis found that psychological interventions significantly reduced parental stress at postintervention but not at 3-6 months' postintervention. Inconclusive evidence was found for the effectiveness of psychological interventions in reducing parental depression and anxiety.

CONCLUSION

Psychological interventions appeared to reduce parental stress temporarily. Healthcare professionals can offer varied psychological interventions for parents to choose from. Policymakers can ease accessibility and affordability for parents to attend interventions.

IMPACT

Psychological interventions were found to have short-term effects in reducing parental stress. Inconclusive evidence was found for the effectiveness of psychological interventions in reducing parental depression and anxiety. Healthcare professionals should ensure that knowledge is transmitted to parents when delivering their interventions. Policymakers worldwide should ensure that parents of children and adolescents with developmental disabilities can attend interventions by making them accessible and affordable.

摘要

目的

评估心理干预在降低儿童和青少年发育障碍父母的压力、抑郁和焦虑方面的有效性。

设计

系统评价和荟萃分析。

资料来源

从每个数据库的起始点到 2018 年 12 月,在 7 个电子数据库(CINAHL、CENTRAL、EMBASE、ProQuest 论文和论文、PsycINFO、PubMed 和 Scopus)中进行了搜索。

审查方法

使用 Cochrane 偏倚风险工具进行质量评估。使用 Review Manager 5.3 分析数据。使用推荐评估、制定和评估系统(Grading of Recommendations Assessment, Development and Evaluation system)评估证据的总体质量。

结果

本综述共纳入 18 项研究。11 项研究进行了荟萃分析,其余 7 项研究进行了叙述性总结。荟萃分析发现,心理干预在干预后显著降低了父母的压力,但在干预后 3-6 个月时没有降低。心理干预对降低父母抑郁和焦虑的有效性的证据尚不清楚。

结论

心理干预似乎能暂时减轻父母的压力。医疗保健专业人员可以为父母提供各种心理干预措施供其选择。政策制定者可以为父母参加干预提供便利和负担得起的途径。

影响

心理干预在降低父母压力方面具有短期效果。心理干预对降低父母抑郁和焦虑的有效性的证据尚不清楚。医疗保健专业人员在提供干预措施时,应确保将知识传递给父母。世界各地的政策制定者应确保发育障碍儿童和青少年的父母能够通过提供可及性和负担能力来参加干预。

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