系统评价脑卒中家庭照料者和双干预的证据。
Systematic Review of the Evidence for Stroke Family Caregiver and Dyad Interventions.
机构信息
University of Cincinnati College of Nursing, OH (T.B., E.L.M.).
Department of Social Work, Northern Arizona University, Flagstaff (M.J.M.).
出版信息
Stroke. 2022 Jun;53(6):2093-2102. doi: 10.1161/STROKEAHA.121.034090. Epub 2022 Mar 10.
Stroke family caregiver and dyad literature has expanded over the past few years. The purpose of this review was to build upon 2 prior systematic reviews to critique, analyze, and synthesize the evidence pertaining to the impact of family caregiver and dyad interventions on stroke survivor and family caregiver outcomes. CINAHL, PsychINFO, PubMed, and reference lists were searched from December 1, 2016 through March 31, 2021. Using PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), articles were identified that tested outcomes from stroke family caregiver or dyad interventions that targeted the health or well-being of family caregivers. Data from the articles were abstracted into tables for analysis, then compared with recommendations from the 2 prior systematic reviews. A total of 18 articles met inclusion criteria (10 caregiver interventions; 8 dyad interventions) representing sample sizes ranging from 7 to 349 caregivers or dyads. Most were randomized controlled trials (n=13); 2 were cluster randomized trials; and 3 were single-group quasi-experimental designs. Of the 18 studies, 8 had <50 caregivers or dyads and 5 were small feasibility studies that reported data trends rather than testing for significance. Only 6 studies reported significant survivor outcomes. Eleven studies reported significant caregiver outcomes, the most common being burden. A number of survivor and caregiver outcomes were not significant, or only significant for certain subgroups. The limited number of studies, small sample sizes, and conflicting results, made it difficult to draw firm conclusions regarding the impact of these interventions on outcomes. Based on the available evidence from these 18 studies, recommendations from the 2 prior reviews were generally supported. Well-designed and well-powered randomized controlled clinical trials are still needed to confirm efficacy of stroke family caregiver and dyad interventions.
中风患者家庭照顾者和二人组文献在过去几年中不断增加。本综述的目的是在前两次系统综述的基础上，对与家庭照顾者和二人组干预对中风幸存者和家庭照顾者结果的影响相关的证据进行批评、分析和综合。从 2016 年 12 月 1 日至 2021 年 3 月 31 日，在 CINAHL、PsychINFO、PubMed 和参考文献列表中进行了搜索。使用 PRISMA 指南（系统评价和荟萃分析的首选报告项目），确定了测试针对家庭照顾者健康或福祉的中风家庭照顾者或二人组干预措施结果的文章。将文章中的数据摘录到表格中进行分析，然后与前两次系统综述的建议进行比较。共有 18 篇文章符合纳入标准（10 项照顾者干预措施；8 项二人组干预措施），代表的照顾者或二人组样本量从 7 到 349 不等。大多数是随机对照试验（n=13）；2 项为集群随机试验；3 项为单组准实验设计。在 18 项研究中，8 项研究的照顾者或二人组人数<50，5 项研究是小型可行性研究，仅报告数据趋势，而不测试显著性。只有 6 项研究报告了显著的幸存者结果。11 项研究报告了显著的照顾者结果，最常见的是负担。许多幸存者和照顾者的结果没有意义，或者仅对某些亚组有意义。由于研究数量有限、样本量小以及结果相互矛盾，因此难以就这些干预措施对结果的影响得出明确结论。基于这 18 项研究的现有证据，前两次综述的建议得到了普遍支持。仍需要精心设计和充分有力的随机对照临床试验来确认中风家庭照顾者和二人组干预措施的疗效。
Zotero 插件