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痴呆症患者照料者的远程健康干预——随机对照试验的系统评价与荟萃分析

Tele-Health Intervention for Carers of Dementia Patients-A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

作者信息

Zhu Aiyong, Cao Wenting, Zhou Yinghua, Xie Anan, Cheng Yun, Chu Shu-Fen

机构信息

College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, China.

Department of Nursing, Huadong Hospital Affiliated to Fudan University, Shanghai, China.

出版信息

Front Aging Neurosci. 2021 Feb 10;13:612404. doi: 10.3389/fnagi.2021.612404. eCollection 2021.

Abstract

The purpose of this study is to evaluate the major mental health outcomes on dementia patient carers when using psychoeducational programs and psychotherapeutic interventions. A meta-analysis was performed with randomized controlled trials of carers' tele-health interventions from the literature inception to December 31, 2019, using PubMed, EMBASE, and CENTRAL databases for articles. The meta-analysis identified 1,043 results, of which 11 were randomized control trials. Among all 11 randomized control trials, only one study addressed face-to-face contact with online modules of interventions, four studies addressed telephone-based interventions, two studies reported on combined face-to-face contact and phone call interventions, two studies focused on web-based interventions, one study used video and telephone interventions, and one study conducted a computer-telephone integration system of intervention. The updated evidence suggested that there was more efficacy via tele-health interventions in lowering depression for carers of people with dementia. We outlined the delivery formation of intervention to evaluate the effectiveness and processes of major mental health improvements, including depression, burden, anxiety, and quality of life. In this study, tele-health intervention was shown to significantly lower depression and also lower the risk of mental health impairment. Although there was a significant decrease of depression, there were no significant differences in burden, anxiety, and quality of life. Future researchers are encouraged to carry out larger-scale studies; also, further analysis using a standardized assessment tool is suggested for future multi-component tele-health interventions.

摘要

本研究的目的是评估使用心理教育项目和心理治疗干预措施时,对痴呆症患者照料者主要心理健康结局的影响。我们进行了一项荟萃分析,纳入了从文献起始至2019年12月31日期间关于照料者远程医疗干预的随机对照试验,使用PubMed、EMBASE和CENTRAL数据库检索相关文章。该荟萃分析共识别出1043项结果,其中11项为随机对照试验。在所有11项随机对照试验中,只有一项研究涉及面对面接触与在线干预模块,四项研究涉及基于电话的干预,两项研究报告了面对面接触与电话干预相结合的情况,两项研究聚焦于基于网络的干预,一项研究使用了视频和电话干预,还有一项研究采用了计算机 - 电话集成系统进行干预。最新证据表明,通过远程医疗干预,痴呆症患者照料者的抑郁水平降低更为有效。我们概述了干预的实施形式,以评估主要心理健康改善(包括抑郁、负担、焦虑和生活质量)的有效性和过程。在本研究中,远程医疗干预被证明能显著降低抑郁水平,还能降低心理健康受损的风险。虽然抑郁水平有显著下降,但在负担、焦虑和生活质量方面没有显著差异。鼓励未来的研究人员开展更大规模的研究;此外,建议在未来的多成分远程医疗干预中使用标准化评估工具进行进一步分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b546/7902496/50123d7ae93f/fnagi-13-612404-g0001.jpg

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