Division of Psychiatry, Marie Curie Palliative Care Research Department, UCL, London, UK.
Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
Palliat Med. 2021 Jul;35(7):1323-1343. doi: 10.1177/02692163211013248. Epub 2021 May 29.
Emotional disclosure is the therapeutic expression of emotion. It holds potential as a means of providing psychological support. However, evidence of its efficacy in palliative settings is mixed. This may be due to variation in intervention characteristics.
To derive a greater understanding of the characteristics of potentially effective emotional disclosure-based interventions in palliative care by:(1) Developing a taxonomy of emotional disclosure-based interventions tested in people with advanced disease and(2) Mapping and linking objectives, outcomes, underlying mechanisms, and implementation factors.
A scoping review drawing on Intervention Component Analysis to combine evidence from studies' methods, results, and discussion sections.
Six databases were searched to May 2020 including CINAHL, PsycINFO, and MEDLINE. Studies of emotional disclosure in adults with advanced disease were included. Study quality was appraised using an established tool.
Seven thousand seven hundred ninety-two unique records were screened, of which 25 primary studies were included. Intervention characteristics were grouped into classes within three domains: topic of disclosure, format, and dose. Evidence was not available to determine which, if any, of the characteristics is most effective. Thematic synthesis of evidence from methods and discussion sections identified factors to consider in tailoring an emotional disclosure-based intervention to this setting, including: population characteristics (e.g. time since diagnosis), providing a safe environment, and flexibility in format.
This review approach facilitated a clearer understanding of factors that may be key in developing emotional disclosure-based interventions for palliative populations. Intervention Component Analysis has potential for application elsewhere to help develop evidence-based interventions.
情感表达是一种治疗性的情感表达。它有提供心理支持的潜力。然而，其在姑息治疗环境中的疗效证据参差不齐。这可能是由于干预措施的特点不同。
通过以下方式深入了解姑息治疗中潜在有效的基于情感表达的干预措施的特点：（1）制定在晚期疾病患者中进行测试的基于情感表达的干预措施分类法，（2）映射和链接目标、结果、潜在机制和实施因素。
一项范围综述，借鉴干预成分分析，将来自研究方法、结果和讨论部分的证据结合起来。
截至 2020 年 5 月，共检索了 6 个数据库，包括 CINAHL、PsycINFO 和 MEDLINE。纳入了成人晚期疾病患者的情感表达研究。使用既定工具评估研究质量。
筛选了 7792 条独特的记录，其中包括 25 项主要研究。将干预措施的特点分为三个领域的类别：披露主题、格式和剂量。没有证据表明哪些特征是最有效的。方法和讨论部分的证据主题综合分析确定了在为这一环境量身定制基于情感表达的干预措施时需要考虑的因素，包括：人口特征（例如诊断后时间）、提供安全的环境以及格式的灵活性。
这种综述方法使我们更清楚地了解了在姑息治疗人群中开发基于情感表达的干预措施的关键因素。干预成分分析有可能在其他地方应用，以帮助开发基于证据的干预措施。
