School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
Complement Ther Med. 2020 Mar;49:102341. doi: 10.1016/j.ctim.2020.102341. Epub 2020 Feb 7.
Present review aimed to conduct a comprehensive review of the effectiveness of non-pharmacological interventions (NPIs) on reducing anxiety in adult burn patients.
We searched PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar databases through September 2019 for randomized clinical trials comparing NPIs to a control group. The primary outcomes were general anxiety and pain anxiety. The Cochrane Risk of Bias Tool was used to assess the risk of bias. All data was pooled with Revman 5.3.
20 studies were eligible for quantitative synthesis. Compared to routine care, Music (4 Randomized Clinical Trials (RCTs), Standardized Mean Difference (SMD) = -2.00, 95 % Confidence Interval (CI) = -3.21 to -0.79), massage (4 RCTs, SMD= -1.84, 95 % CI= -2.77 to -0.91), hypnosis (2 RCTs, SMD= -1.06, 95 % CI= -2.90 to 0.78), relaxation (2 RCTs, SMD= -0.77, 95 %CI= -1.52 to -0.02), transcranial direct current stimulation (1 RCT, SMD= -1.92, 95 %CI= -2.54 to -1.30), and therapeutic touch practices (1 RCT, SMD=-0.45 95 %CI= -0.86 to -0.04), were associated with a significant effect on the anxiety of burn patients. Aromatherapy interventions and virtual reality showed no evidence of a reduction in the anxiety. A large amount of heterogeneity exist among trials. Risk of bias varied across studies. Only one study reported on safety issues.
Due to weak evidence, we are unable to make strong recommendations in favor of NPIs for burn anxiety. Further well-designed large sample size randomized clinical trials are warranted.
本综述旨在全面评估非药物干预（NPIs）对成人烧伤患者焦虑的疗效。
我们检索了 PubMed、Web of Science、Scopus、Cochrane Library 和 Google Scholar 数据库，以获取截至 2019 年 9 月比较 NPIs 与对照组的随机临床试验。主要结局为一般焦虑和疼痛焦虑。使用 Cochrane 偏倚风险工具评估偏倚风险。所有数据均使用 Revman 5.3 进行汇总。
20 项研究符合定量综合条件。与常规护理相比，音乐（4 项随机临床试验（RCTs），标准化均数差（SMD）=-2.00，95%置信区间（CI）=-3.21 至-0.79），按摩（4 RCTs，SMD=-1.84，95%CI=-2.77 至-0.91），催眠（2 RCTs，SMD=-1.06，95%CI=-2.90 至 0.78），放松（2 RCTs，SMD=-0.77，95%CI=-1.52 至-0.02），经颅直流电刺激（1 RCT，SMD=-1.92，95%CI=-2.54 至-1.30）和治疗性触摸疗法（1 RCT，SMD=-0.45，95%CI=-0.86 至-0.04）与烧伤患者焦虑的显著改善相关。芳香疗法干预和虚拟现实技术并未显示出焦虑减轻的证据。试验之间存在大量异质性。研究的偏倚风险各不相同。只有一项研究报告了安全性问题。
由于证据薄弱，我们无法强烈推荐 NPIs 用于烧伤焦虑。需要进一步进行设计良好、样本量大的随机临床试验。
