Boggiss Anna L, Consedine Nathan S, Brenton-Peters Jennifer M, Hofman Paul L, Serlachius Anna S
Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Liggins Institute, University of Auckland, Auckland, New Zealand.
J Psychosom Res. 2020 Aug;135:110165. doi: 10.1016/j.jpsychores.2020.110165. Epub 2020 Jun 3.
Gratitude interventions are easy-to-deliver, offering promise for use in clinical-care. Although gratitude interventions have consistently shown benefits to psychological wellbeing, the effects on physical health outcomes are mixed. This systematic review aims to synthesize gratitude intervention studies which assessed physical health and health behavior outcomes, as well as evaluate study quality, comment on their efficacy, and provide directions for future research.
Relevant studies were identified through searches conducted in PsycINFO, MedLine, Embase and Cochrane Library databases, up until August 2019. Only studies that evaluated a gratitude intervention, randomly assigned participants to gratitude and control conditions, and assessed objective and subjective measures of physical health and health behaviors were included. The Revised Cochrane risk-of-bias (RoB2) tool was used to assess risk of bias.
Of the 1433 articles found, 19 were included in the review. Subjective sleep quality was improved in 5/8 studies. Improvements in blood pressure, glycemic control, asthma control and eating behavior were understudied yet demonstrated improvements (all 1/1). Other outcome categories remain understudied and mixed, such as inflammation markers (1/2) and self-reported physical symptoms (2/8). The majority of studies showed some risk of bias concerns.
Although it was suggested gratitude interventions may improve subjective sleep quality, more research is still needed to make firm conclusions on the efficacy of gratitude interventions on improving health outcomes. Further research focusing on gratitude's link with sleep and causal mechanisms is needed, especially in patient populations where more 'clinically-usable' psychosocial interventions are urgently needed.
感恩干预易于实施，有望应用于临床护理。尽管感恩干预一直显示出对心理健康有益，但对身体健康结果的影响却参差不齐。本系统评价旨在综合评估身体健康和健康行为结果的感恩干预研究，评估研究质量，评论其疗效，并为未来研究提供方向。
通过检索PsycINFO、Medline、Embase和Cochrane图书馆数据库，直至2019年8月，确定相关研究。仅纳入评估感恩干预、将参与者随机分配到感恩组和对照组，并评估身体健康和健康行为的客观和主观指标的研究。使用修订后的Cochrane偏倚风险（RoB2）工具评估偏倚风险。
在检索到的1433篇文章中，19篇被纳入综述。在8项研究中的5项中，主观睡眠质量得到改善。血压、血糖控制、哮喘控制和饮食行为方面的改善研究较少，但均有改善（均为1/1）。其他结果类别研究较少且结果不一，如炎症标志物（2项研究中的1项）和自我报告的身体症状（8项研究中的2项）。大多数研究存在一些偏倚风险问题。
尽管有研究表明感恩干预可能改善主观睡眠质量，但仍需要更多研究才能就感恩干预改善健康结果的疗效得出确凿结论。需要进一步研究感恩与睡眠的关系及其因果机制，特别是在迫切需要更多“临床可用”心理社会干预的患者群体中。
