11种非药物干预措施对痴呆症患者非正式照料者的抑郁、焦虑、生活质量及照料者负担的比较疗效：一项系统评价和网状Meta分析

Comparative efficacy of 11 non-pharmacological interventions on depression, anxiety, quality of life, and caregiver burden for informal caregivers of people with dementia: A systematic review and network meta-analysis.

作者信息

Sun Yue, Ji Mengmeng, Leng Minmin, Li Xinrui, Zhang Xueer, Wang Zhiwen

机构信息

School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, China.

Department of Epidemiology, School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.

出版信息

Int J Nurs Stud. 2022 May;129:104204. doi: 10.1016/j.ijnurstu.2022.104204. Epub 2022 Feb 12.

DOI:10.1016/j.ijnurstu.2022.104204

PMID:35247788

Abstract

BACKGROUND

In recent years, numerous dementia caregiving interventions for informal caregivers of community-dwelling people with dementia have been developed. However, it remains unclear which non-pharmacological interventions are effective and preferred for their depression and anxiety symptoms, quality of life, and caregiver burden.

OBJECTIVES

To compare and rank the efficacy of different non-pharmacological interventions on depression, anxiety, quality of life, and caregiver burden for informal caregivers of people with dementia.

DESIGN

A systematic review and network meta-analysis.

METHODS

Relevant randomized controlled trials on the efficacy of non-pharmacological interventions for informal caregivers of people with dementia were extracted from seven electronic databases. A network meta-analysis was then performed to evaluate the relative efficacy of the non-pharmacological interventions for informal caregivers of people with dementia. The quality of the data was assessed using the Cochrane Risk of Bias tool.

RESULTS

A total of 85 randomized controlled trials on 11 non-pharmacological interventions were included in the final analysis. Acceptance and commitment therapy, behavioral activation, mindfulness-based intervention, multicomponent intervention, psychoeducation, and cognitive behavioral therapy might reduce depression. Notably, psychoeducation was the only effective intervention against anxiety. Only support groups had a statistically significant effect on the quality of life. When considering decreasing caregiver burden, case management, psychoeducation, and multicomponent intervention would be the effective interventions.

CONCLUSIONS

Several non-pharmacological interventions seemed to be effective in treating depression and anxiety, improving quality of life, and reducing caregiver burden for informal caregivers of people with dementia. Healthcare professionals should be encouraged to apply these non-pharmacological interventions for informal caregivers of people with dementia during routine care.

摘要

背景

近年来，针对社区痴呆症患者的非正式照料者，已开发出众多痴呆症照料干预措施。然而，对于其抑郁和焦虑症状、生活质量及照料者负担而言，哪些非药物干预措施有效且更受青睐仍不明确。

目的

比较并排序不同非药物干预措施对痴呆症患者非正式照料者的抑郁、焦虑、生活质量及照料者负担的疗效。

设计

系统评价与网状Meta分析。

方法

从七个电子数据库中提取有关痴呆症患者非正式照料者非药物干预措施疗效的相关随机对照试验。随后进行网状Meta分析，以评估非药物干预措施对痴呆症患者非正式照料者的相对疗效。使用Cochrane偏倚风险工具评估数据质量。

结果

最终分析纳入了关于11种非药物干预措施的85项随机对照试验。接纳与承诺疗法、行为激活、基于正念的干预、多成分干预、心理教育及认知行为疗法可能减轻抑郁。值得注意的是，心理教育是唯一对焦虑有效的干预措施。只有支持小组对生活质量有统计学显著影响。在考虑减轻照料者负担时，个案管理、心理教育及多成分干预将是有效的干预措施。