College of Social Work, The Ohio State University, Columbus (Ms Coxe and Dr Liu); and School of Social Work (Dr Moore) and Harborview Injury Prevention and Research Center (Dr Moore), University of Washington.
J Head Trauma Rehabil. 2020 Nov/Dec;35(6):E535-E546. doi: 10.1097/HTR.0000000000000587.
To identify and examine research on telebehavioral interventions that support family caregivers of individuals with traumatic brain injury (TBI).
A systematic review using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies published between 1999 and 2019 were identified through CINHAL, EMBASE, ERIC, PsycINFO, PubMed, Scopus, and Web of Science.
Twelve studies met inclusion criteria; 3 used quasi-experimental designs, 7 were randomized controlled trials (RCTs) with 1-group comparison, 1 was RCT with a 2-group comparison, and 1 was RCT with a 3-group comparison. Outcomes primarily focused on caregiver depression, distress, self-efficacy, anxiety, stress, burden, and problem solving. Eleven studies found significant differences between the intervention and control groups on at least 1 outcome indicator, and 10 of these reported effect sizes supporting clinical significance. However, studies lacked data on caregiver and injury characteristics, and most studies lacked diverse study samples that may contribute to psychosocial outcomes. Nearly all studies demonstrated methodological bias (PEDro-P M = 5.5).
Caregiver psychosocial outcomes following telebehavioral interventions were generally positive, but caution should be used when generalizing outcomes due to lack of sample diversity. Additional research is needed to assess how caregiver demographics and injury severity moderate caregiver outcomes.
确定并研究支持创伤性脑损伤（TBI）患者家属的远程行为干预措施的研究。
采用 PRISMA（系统评价和荟萃分析的首选报告项目）指南进行系统评价。通过 CINHAL、EMBASE、ERIC、PsycINFO、PubMed、Scopus 和 Web of Science 确定了 1999 年至 2019 年期间发表的研究。
符合纳入标准的有 12 项研究；3 项采用准实验设计，7 项为仅 1 组比较的随机对照试验（RCT），1 项为 2 组比较的 RCT，1 项为 3 组比较的 RCT。结果主要集中在照顾者的抑郁、痛苦、自我效能、焦虑、压力、负担和解决问题能力上。11 项研究在至少 1 项结局指标上发现干预组和对照组之间存在显著差异，其中 10 项研究报告的效应大小支持临床意义。然而，这些研究缺乏关于照顾者和损伤特征的数据，而且大多数研究缺乏可能对社会心理结局有影响的多样化研究样本。几乎所有研究都存在方法学偏倚（PEDro-P M = 5.5）。
远程行为干预后的照顾者心理社会结局通常是积极的，但由于缺乏样本多样性，在推广结果时应谨慎。需要进一步研究以评估照顾者人口统计学和损伤严重程度如何调节照顾者结局。
