多层次弹性资源与美国心血管疾病:系统评价和荟萃分析。
Multilevel resilience resources and cardiovascular disease in the United States: A systematic review and meta-analysis.
机构信息
Center for Epidemiologic Research.
Center for Health Promotion and Health Equity Research.
出版信息
Health Psychol. 2022 Apr;41(4):278-290. doi: 10.1037/hea0001069. Epub 2021 Jun 17.
This systematic review and meta-analysis aimed to quantify the relationship between resilience resources at the individual (e.g., optimism), interpersonal (e.g., social support), and neighborhood (e.g., social environment) levels, and cardiovascular outcomes among adults in the United States. On 9/25/2020, electronic databases (PubMed, Embase, CINAHL, PsycINFO) were systematically searched for randomized controlled trials, nonrandomized intervention studies, and prospective cohort studies that examined the relationship between resilience resources at the individual, interpersonal, or neighborhood level and cardiovascular outcomes. Studies that met the eligibility criteria were summarized narratively and quantitatively. Because relevant search results yielded only observational studies, risk of bias was assessed using an adapted version of the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool. From 4,103 unique records, 13 prospective cohort studies with a total of 310,906 participants met the eligibility criteria, and six of these studies were included in the meta-analyses. Most relevant studies found that higher levels of individual-level resilience resources were associated with lower incidence of adverse cardiovascular outcomes, with point estimates ranging from .46 to 1.18. Interpersonal-level resilience resources (i.e., social network) were associated with a lower coronary heart disease risk (risk ratio, .76; 95% CI [.56, 1.02]). Neighborhood-level resilience resources (i.e., perceived social cohesion and residential stability) were associated with a lower odds of stroke (odds ratio, .92; 95% CI [.84, 1.01]). Evidence suggests that higher levels of resilience resources are associated with better cardiovascular outcomes. However, more prospective studies with diverse populations are needed to strengthen the evidence. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
本系统评价和荟萃分析旨在量化个体(如乐观主义)、人际(如社会支持)和社区(如社会环境)层面的复原力资源与美国成年人心血管结局之间的关系。于 2020 年 9 月 25 日,系统检索了电子数据库(PubMed、Embase、CINAHL、PsycINFO),以查找个体、人际或社区层面的复原力资源与心血管结局之间关系的随机对照试验、非随机干预研究和前瞻性队列研究。符合入选标准的研究进行了叙述性和定量总结。由于相关检索结果仅为观察性研究,因此使用干预非随机研究的偏倚风险(ROBINS-I)工具的改编版本评估了偏倚风险。从 4103 条独特记录中,有 13 项前瞻性队列研究(共 310906 名参与者)符合入选标准,其中 6 项研究纳入荟萃分析。大多数相关研究发现,个体层面的复原力资源水平较高与不良心血管结局的发生率较低相关,点估计值范围为.46 至 1.18。人际层面的复原力资源(即社交网络)与冠心病风险降低相关(风险比,.76;95%CI [.56, 1.02])。社区层面的复原力资源(即感知社会凝聚力和居住稳定性)与中风几率降低相关(比值比,.92;95%CI [.84, 1.01])。证据表明,较高水平的复原力资源与更好的心血管结局相关。然而,需要更多具有不同人群的前瞻性研究来加强证据。(PsycInfo 数据库记录(c)2022 APA,保留所有权利)。
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