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藻酸盐伤口敷料在预防和治疗Ⅱ期和Ⅲ期压疮中的应用:系统评价和荟萃分析

Phycological debriefing in acute traumatic events: Evidence synthesis.

机构信息

Grupo de Investigación en Resiliencia, Adversidad y Reparación (GIRAR), Viña del Mar, Chile; Centro Interdisciplinario de Estudios en Salud (CIESAL), Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Viña del Mar, Chile. Email:

Grupo de Investigación en Resiliencia, Adversidad y Reparación (GIRAR), Viña del Mar, Chile; Cátedra de Psiquiatría Infanto-juvenil, Departamento de Pediatría, Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Viña del Mar, Chile.

出版信息

Medwave. 2022 Jan 18;22(1):e8517. doi: 10.5867/medwave.2022.01.002538.

Abstract

Stressful life situations can generate chronic symptomatology, so it is of great concern to analyze preventive strategies. Psychological debriefing is an intervention for acute trauma, which verbalizes perceptions, thoughts, and emotions experienced during a recent traumatic event. The evidence surrounding its efficacy is controversial. This article discusses the efficacy of psychological debriefing based on systematic reviews and clinical practice guidelines. In all, nine systematic reviews were included. Only one of them found that psychological debriefing effectively decreased psychological stress, while the remaining eight found no significant effects for outcomes such stress, depressive and anxious symptoms, or development and severity of post-traumatic stress disorder. Moreover, two clinical trials found that the intervention had a significantly deleterious effect. Another study found a worsening in the symptomatology associated with the event. Of the eight clinical practice guidelines incorporated, none recommended psychological debriefing as an intervention for acute trauma. Some phenomena could explain the lack of success of the intervention in the scientific evidence. The bioethical conditions related to the traumatic scenario hinder its research, and its lack of standardization makes its evaluation in clinical trials problematic. Other variables such as ethnicity, personality, culture, gender, and history of traumatic experiences have been little considered in research. Nevertheless, the intervention may hinder the adequate processing of traumatic memory and emotions. Current evidence is consistent in not recommending psychological debriefing as an intervention for acute trauma, so its management should avoid it. It is suggested to promote research on preventive interventions to develop chronic traumatic symptomatology.

摘要

紧张的生活情境会引发慢性症状,因此分析预防策略至关重要。心理疏导是一种针对急性创伤的干预措施,它可以表达人们在近期创伤性事件中经历的感知、想法和情绪。围绕其疗效的证据存在争议。本文根据系统评价和临床实践指南讨论了心理疏导的疗效。共纳入了 9 项系统评价。只有一项发现心理疏导能有效降低心理压力,而其余八项发现心理疏导对压力、抑郁和焦虑症状、创伤后应激障碍的发展和严重程度等结果均无显著影响。此外,两项临床试验发现该干预措施具有明显的不良影响。另一项研究发现,干预后与事件相关的症状恶化。纳入的 8 项临床实践指南中,没有一项建议将心理疏导作为急性创伤的干预措施。一些现象可以解释该干预措施在科学证据中缺乏成功的原因。与创伤场景相关的生物伦理条件阻碍了其研究,其缺乏标准化使得其在临床试验中的评估变得复杂。其他变量,如种族、性格、文化、性别和创伤经历史,在研究中很少被考虑。然而,该干预措施可能会阻碍对创伤性记忆和情绪的适当处理。目前的证据一致表明,不建议将心理疏导作为急性创伤的干预措施,因此在管理时应避免使用。建议促进预防干预措施的研究,以预防慢性创伤性症状的发生。

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