Kustanti Christina Yeni, Fang Hui-Fen, Linda Kang Xiao, Chiou Jeng-Fong, Wu Shen-Chi, Yunitri Ninik, Chu Hsin, Chou Kuei-Ru
PhD Student of School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan and Lecturer of Sekolah Tinggi Ilmu Kesehatan Bethesda Yakkum, Yogyakarta, Indonesia.
Director of Nursing department, Taipei Cancer Center, Taipei Medical University, Deputy Director of Cancer Center, Taipei Medical University Hospital and Deputy Director of Nursing Service, Taipei Medical University Hospital, Taipei, Taiwan.
J Nurs Scholarsh. 2021 Mar;53(2):208-217. doi: 10.1111/jnu.12630. Epub 2021 Feb 5.
This meta-analysis aimed to summarize and synthesize the effectiveness of bereavement support for adult family caregivers in palliative care.
Meta-analysis was conducted. The databases of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane, Embase, Medline, PubMed, Scopus, and Web of Science were comprehensively searched from inception until January 2020. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and standard methods for conducting a meta-analysis. Data analysis was performed using Comprehensive Meta-analysis version 3.0, and the random-effects model was adopted.
In total, 19 randomized controlled trials with an overall sample size of 2,690 participants met the inclusion criteria. The study showed that bereavement support had a significant effect on reducing grief (Hedges' g score = -0.198; 95% confidence interval [CI] -0.310 to -0.087), depression (Hedges' g score = -0.252; 95% CI -0.406 to -0.098), and anxiety (Hedges' g score = -0.153; 95% CI -0.283 to -0.023); however, high heterogeneity was present. No statistically significant difference was shown for traumatic feelings. Based on moderator analysis, a group format was more effective for grief, a combined individual and group format for depression, and an individual format for anxiety. Bereavement support was more effective when delivered by professionals, when delivered in more than six sessions, and need to be evaluated within 6 months.
Bereavement support was effective in reducing grief, depression, and anxiety. The majority of the included studies had moderate heterogeneity, which limited the comparability of the evidence. Therefore, more robust randomized controlled trials are needed to confirm these study results.
This meta-analysis provides evidence that bereavement support delivered in the palliative care setting is effective for reducing grief, depression, and anxiety. Nurses and other healthcare professionals can make recommendations for adult family caregivers based on this study in reducing psychological symptoms due to a loss in the palliative care domain.
本荟萃分析旨在总结和综合姑息治疗中丧亲之痛支持对成年家庭照顾者的有效性。
进行荟萃分析。全面检索了护理及相关健康文献累积索引（CINAHL）、Cochrane、Embase、Medline、PubMed、Scopus和Web of Science数据库，从建库至2020年1月。本研究遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南及进行荟萃分析的标准方法。使用综合荟萃分析3.0版进行数据分析，并采用随机效应模型。
共有19项随机对照试验符合纳入标准，总样本量为2690名参与者。研究表明，丧亲之痛支持在减轻悲伤（赫奇斯g值=-0.198；95%置信区间[CI]-0.310至-0.087）、抑郁（赫奇斯g值=-0.252；95%CI-0.406至-0.098）和焦虑（赫奇斯g值=-0.153；95%CI-0.283至-0.023）方面有显著效果；然而，存在高度异质性。在创伤性感受方面未显示出统计学显著差异。基于调节因素分析，团体形式对悲伤更有效，个体与团体相结合的形式对抑郁更有效，个体形式对焦虑更有效。由专业人员提供丧亲之痛支持、提供超过六次疗程时更有效，且需要在6个月内进行评估。
丧亲之痛支持在减轻悲伤、抑郁和焦虑方面有效。大多数纳入研究具有中度异质性，这限制了证据的可比性。因此，需要更有力的随机对照试验来证实这些研究结果。
本荟萃分析提供了证据，表明在姑息治疗环境中提供的丧亲之痛支持在减轻悲伤、抑郁和焦虑方面有效。护士和其他医疗保健专业人员可基于本研究为成年家庭照顾者提供建议，以减轻姑息治疗领域中因丧失亲人导致的心理症状。
