Gillian E. Cassar, DPsych, School of Psychology, Deakin University, Geelong, Australia.
George J. Youssef, PhD, MPsych, School of Psychology, Deakin University, Geelong, Australia; and The Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
Gastroenterol Nurs. 2020 May/Jun;43(3):E102-E122. doi: 10.1097/SGA.0000000000000530.
Irritable bowel syndrome (IBS) affects up to 20% of the global population and is associated with impaired health-related quality of life (HRQoL). This systematic review and meta-analysis aimed to investigate differences in HRQoL of those with IBS compared with healthy controls and to examine whether HRQoL improves following psychological intervention. Online databases were searched for articles from 2002 to 2017. Studies were screened and data extracted according to predetermined criteria. A total of 4,154 citations were identified from which 36 were eligible for inclusion. Eight studies compared HRQoL of those with IBS (n = 822) with that of healthy individuals (n = 3,809). Those with IBS suffered significant impairment across all HRQoL domains compared with healthy individuals, with the majority of effects (Cohen's d) being moderate to large. Twenty-eight studies investigated HRQoL in IBS following psychological intervention (n = 1,308) relative to controls (n = 1,006). All HRQoL domains improved with large effects following treatment; however, maintenance of these effects was inconsistent. Those with IBS experience poorer HRQoL than the wider community; nevertheless, psychological interventions are associated with improved HRQoL across all domains. High-quality studies are needed to better inform gastroenterological nurses of which interventions are most efficacious in alleviating the burden of IBS, and which IBS subpopulations would benefit.
肠易激综合征(IBS)影响全球多达 20%的人口,与健康相关的生活质量(HRQoL)受损有关。本系统评价和荟萃分析旨在研究与健康对照组相比,IBS 患者的 HRQoL 差异,并探讨心理干预后 HRQoL 是否有所改善。在线数据库检索了 2002 年至 2017 年的文章。根据预定标准筛选和提取数据。从 4154 条引文中确定了 36 篇符合条件的文章。八项研究比较了 IBS 患者(n = 822)与健康个体(n = 3809)的 HRQoL。与健康个体相比,IBS 患者在所有 HRQoL 领域都遭受了显著的损害,大多数影响(Cohen's d)为中度至重度。28 项研究调查了心理干预后 IBS 患者(n = 1308)相对于对照组(n = 1006)的 HRQoL。所有 HRQoL 领域在治疗后均有较大的改善,但这些效果的维持并不一致。与一般人群相比,IBS 患者的 HRQoL 较差;然而,心理干预与所有领域的 HRQoL 改善有关。需要高质量的研究来更好地告知胃肠病护士哪些干预措施最能减轻 IBS 的负担,以及哪些 IBS 亚群将受益。