Division of Psychiatry & Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.
Multiple Sclerosis Patient and Public Involvement Group Lead, Nottingham, UK.
Clin Psychol Rev. 2020 Dec;82:101923. doi: 10.1016/j.cpr.2020.101923. Epub 2020 Sep 22.
This meta-review aimed to synthesise evidence on psychosocial adjustment to multiple sclerosis, to identify available treatment models and services for recently diagnosed individuals, and to explore their effectiveness. MEDLINE, CINAHL, EMBASE, PsycINFO, Web of Science, Cochrane Database of Systematic Reviews and grey literature were searched to include systematic reviews on psychosocial adjustment in multiple sclerosis. Two reviewers independently screened and assessed the quality of the selected reviews. Data were synthesised using narrative approach. Overall, thirty systematic reviews were included (with ~131,813 people with multiple sclerosis). A variety of psychosocial factors were identified in relation to adjustment to multiple sclerosis. Seven theoretical models that underpinned the available services and ten different intervention categories (e.g. cognitive behavioural approaches, mindfulness) for adjustment to multiple sclerosis were identified. There was some evidence that these interventions improved quality of life and coping, however, the difference they could make to people's adjustment was inconclusive. It was also difficult to conclude whether these interventions were particularly effective with the newly diagnosed. There is some support for the effectiveness of adjustment interventions. However, there is a need to design and rigorously evaluate support programmes for newly diagnosed people with multiple sclerosis, specifically focusing on information and adjustment support.
这篇荟萃回顾旨在综合多发性硬化症患者的心理社会适应的证据，确定针对近期诊断个体的现有治疗模式和服务，并探讨其有效性。系统检索了 MEDLINE、CINAHL、EMBASE、PsycINFO、Web of Science、Cochrane 系统评价数据库和灰色文献，以纳入多发性硬化症心理社会适应的系统评价。两位评审员独立筛选并评估了所选综述的质量。使用叙述性方法综合数据。总体而言，纳入了 30 篇系统评价（涉及约 131813 名多发性硬化症患者）。确定了与多发性硬化症适应相关的各种心理社会因素。确定了七个支撑现有服务的理论模型和十个不同的干预类别（例如认知行为方法、正念），用于多发性硬化症的适应。有一些证据表明这些干预措施改善了生活质量和应对能力，但它们对人们适应能力的影响尚无定论。也难以确定这些干预措施对新诊断的患者是否特别有效。调整干预措施的有效性得到了一些支持。然而，需要设计并严格评估针对新诊断多发性硬化症患者的支持计划，特别是重点关注信息和调整支持。
