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围产期失子父母心理结局的心理社会干预:系统评价和荟萃分析。

Psychosocial interventions on psychological outcomes of parents with perinatal loss: A systematic review and meta-analysis.

机构信息

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.

出版信息

Int J Nurs Stud. 2021 May;117:103871. doi: 10.1016/j.ijnurstu.2021.103871. Epub 2021 Jan 12.

Abstract

BACKGROUND

Perinatal loss can occur due to miscarriages and ectopic pregnancies, among other circumstances. Psychological health of parents can deteriorate due to perinatal loss. Parent's negative psychological outcomes include depression, anxiety, and grief.

OBJECTIVE

To evaluate the effectiveness of psychosocial interventions in reducing depression, anxiety, and grief among parents after perinatal loss.

DESIGN

A systematic review and meta-analysis of randomized controlled trials DATA SOURCES: English language articles published from database inception to 19 November 2019 were systematically retrieved from eight electronic databases (CINAHL, Cochrane, EMBASE, ProQuest Dissertations and Theses Global, PsycINFO, PubMed, Scopus, Web of Science).

REVIEW METHODS

The Cochrane Risk of Bias tool was used to conduct quality appraisal of each individual article and data was analyzed using Review Manager 5.3. A meta-analysis of randomized controlled trials was conducted using a random-effect model.

RESULTS

Among this review's 17 included studies, 15 studies' results were included in the meta-analyses. The remaining two studies were summarized narratively. Meta-analyses revealed that psychosocial interventions significantly reduced depression (95% CI: -0.64 to -0.29, Z = 5.17, p = <0.00001), anxiety (95% CI: -0.50 to -0.18, Z = 4.21, p < 0.0001) and grief (95% CI: -0.71 to -0.32, Z = 5.12, p < 0.0001).

CONCLUSION

Psychosocial interventions are effective in improving depression, anxiety, and grief amongst parents with perinatal loss. Psychosocial care can be provided by medical healthcare professionals and expanded with technology-assisted implementation.

STUDY REGISTRATION NUMBER

CRD42019145526.

摘要

背景

围产期损失可由流产和宫外孕等情况引起。围产期损失可导致父母的心理健康恶化。父母的负面心理后果包括抑郁、焦虑和悲伤。

目的

评估心理社会干预在减少围产期损失后父母的抑郁、焦虑和悲伤的有效性。

设计

系统评价和随机对照试验的荟萃分析。

数据来源

从八个电子数据库(CINAHL、Cochrane、EMBASE、ProQuest 学位论文全文数据库全球版、PsycINFO、PubMed、Scopus、Web of Science)系统地检索了从数据库创建到 2019 年 11 月 19 日发表的英文文章。

综述方法

使用 Cochrane 偏倚风险工具对每篇文章进行质量评估,并使用 Review Manager 5.3 分析数据。使用随机效应模型对随机对照试验进行荟萃分析。

结果

在本综述的 17 项纳入研究中,有 15 项研究的结果纳入荟萃分析。其余两项研究以叙述性方式进行总结。荟萃分析显示,心理社会干预显著降低了抑郁(95% CI:-0.64 至-0.29,Z=5.17,p<0.00001)、焦虑(95% CI:-0.50 至-0.18,Z=4.21,p<0.0001)和悲伤(95% CI:-0.71 至-0.32,Z=5.12,p<0.0001)。

结论

心理社会干预可有效改善有围产期损失的父母的抑郁、焦虑和悲伤。医疗保健专业人员可提供心理社会关怀,并结合技术辅助实施进行扩展。

研究注册号

CRD42019145526。

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