二元心理社会电子健康干预措施:系统综述
Dyadic Psychosocial eHealth Interventions: Systematic Scoping Review.
作者信息
Shaffer Kelly M, Tigershtrom Ashley, Badr Hoda, Benvengo Stephanie, Hernandez Marisol, Ritterband Lee M
机构信息
Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, VA, United States.
Memorial Sloan Kettering Cancer Center, New York, NY, United States.
出版信息
J Med Internet Res. 2020 Mar 4;22(3):e15509. doi: 10.2196/15509.
BACKGROUND
Dyadic psychosocial interventions have been found beneficial both for people coping with mental or physical health conditions as well as their family members and friends who provide them with support. Delivering these interventions via electronic health (eHealth) may help increase their scalability.
OBJECTIVE
This scoping review aimed to provide the first comprehensive overview of dyadic eHealth interventions for individuals of all ages affected by mental or physical illness and their family members or friends who support them. The goal was to understand how dyadic eHealth interventions have been used and to highlight areas of research needed to advance dyadic eHealth intervention development and dissemination.
METHODS
A comprehensive electronic literature search of PubMed, EMBASE, Cochrane, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO was conducted for articles published in the English language through March 2019. Eligible records described a psychosocial eHealth intervention that intervened with both care recipients and their support person.
RESULTS
A total of 7113 records were reviewed of which 101 met eligibility criteria. There were 52 unique dyadic eHealth interventions identified, which were tested across 73 different trials. Of the unique interventions, 33 were conducted among dyads of children and their supporting parent, 1 was conducted with an adolescent-young adult care recipient population, and the remaining 18 were conducted among adult dyads. Interventions targeting pediatric dyads most commonly addressed a mental health condition (n=10); interventions targeting adult dyads most commonly addressed cancer (n=9). More than three-fourths of interventions (n=40) required some human support from research staff or clinicians. Most studies (n=64) specified one or more primary outcomes for care recipients, whereas less than one-fourth (n=22) specified primary outcomes for support persons. Where specified, primary outcomes were most commonly self-reported psychosocial or health factors for both care recipients (n=43) and support persons (n=18). Results of the dyadic eHealth intervention tended to be positive for care recipients, but evidence of effects for support persons was limited because of few studies specifying primary outcomes for supporters. Trials of dyadic eHealth interventions were most commonly randomized controlled trials (RCTs; n=44), and RCTs most commonly compared the dyadic eHealth intervention to usual care alone (n=22).
CONCLUSIONS
This first comprehensive review of dyadic eHealth interventions demonstrates that there is substantial, diverse, and growing literature supporting this interventional approach. However, several significant gaps were identified. Few studies were designed to evaluate the unique effects of dyadic interventions relative to individual interventions. There was also limited assessment and reporting of outcomes for support persons, and there were no interventions meeting our eligibility criteria specifically targeting the needs of older adult dyads. Findings highlight areas of research opportunities for developing dyadic eHealth interventions for novel populations and for increasing access to dyadic care.
背景
二元心理社会干预已被发现对应对心理或身体健康状况的人及其提供支持的家人和朋友均有益处。通过电子健康(eHealth)提供这些干预措施可能有助于提高其可扩展性。
目的
本范围综述旨在首次全面概述针对受精神或身体疾病影响的各年龄段个体及其支持他们的家人或朋友的二元电子健康干预措施。目标是了解二元电子健康干预措施的使用方式,并突出推进二元电子健康干预措施开发和传播所需的研究领域。
方法
对PubMed、EMBASE、Cochrane、护理及相关健康文献累积索引和PsycINFO进行了全面的电子文献检索,以查找截至2019年3月发表的英文文章。符合条件的记录描述了一种心理社会电子健康干预措施,该措施同时干预了受护理者及其支持者。
结果
共审查了7113条记录,其中101条符合纳入标准。确定了52种独特的二元电子健康干预措施,这些措施在73项不同的试验中进行了测试。在这些独特的干预措施中,33项是在儿童及其支持父母的二元组中进行的,1项是针对青少年 - 青年成人受护理者群体进行的,其余18项是在成人二元组中进行的。针对儿科二元组的干预措施最常涉及心理健康状况(n = 10);针对成人二元组的干预措施最常涉及癌症(n = 9)。超过四分之三的干预措施(n = 40)需要研究人员或临床医生提供一些人力支持。大多数研究(n = 64)为受护理者指定了一个或多个主要结局,而指定支持人员主要结局的研究不到四分之一(n = 22)。在指定的情况下,主要结局最常见的是受护理者(n = 43)和支持人员(n = 18)自我报告的心理社会或健康因素。二元电子健康干预措施对受护理者的结果往往是积极的,但由于很少有研究为支持者指定主要结局,因此支持人员的效果证据有限。二元电子健康干预措施的试验最常见的是随机对照试验(RCT;n = 44),而RCT最常将二元电子健康干预措施与单独的常规护理进行比较(n = 22)。
结论
对二元电子健康干预措施的首次全面综述表明,有大量、多样且不断增长的文献支持这种干预方法。然而,发现了几个重大差距。很少有研究旨在评估二元干预相对于个体干预的独特效果。对于支持人员的结局评估和报告也有限,并且没有符合我们纳入标准的专门针对老年二元组需求的干预措施。研究结果突出了为新人群开发二元电子健康干预措施以及增加二元护理可及性的研究机会领域。