接受与承诺疗法对改善多发性硬化症患者生活质量和情绪的有效性：系统评价和荟萃分析。
Effectiveness of acceptance and commitment therapy for improving quality of life and mood in individuals with multiple sclerosis: A systematic review and meta-analysis.
机构信息
Trent Doctorate in Clinical Psychology, Institute of Mental Health, University of Nottingham, Innovation Park, Triumph Road, NG7 2TU, UK; Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK.
Trent Doctorate in Clinical Psychology, University of Lincoln, UK.
出版信息
Mult Scler Relat Disord. 2022 Jul;63:103862. doi: 10.1016/j.msard.2022.103862. Epub 2022 May 10.
OBJECTIVE
To review the evidence for the effectiveness of Acceptance and Commitment Therapy (ACT) intervention on quality of life and mood, for individuals with Multiple Sclerosis (MS).
METHOD
A systematic search was conducted of PsycINFO, CINAHL, Embase, MEDLINE, Web of Science, Scopus and ContextualScience.org up to 13/01/2022. Grey literature was also searched via ProQuest Dissertations and Theses, and PROSPERO. We included Randomised Controlled Trials (RCTs) published in English, that examined the effectiveness of ACT for people with a diagnosis of MS. We were interested in outcomes of Quality of Life (QoL), mood (e.g., anxiety, depression and stress), and ACT-targeted processes. Methodological quality was assessed using the Cochrane Risk of Bias Tool v2. Where available, the extracted data were entered into a meta-analysis to determine weighted effect size estimates for the outcomes of interest.
RESULTS
Six studies (191 participants), out of 142 identified, met inclusion criteria. Meta-analyses indicated a statistically significant small effect on stress (SMD = -0.49 [95% CI of -0.89 - -0.08]), in favour of ACT. There were no statistically significant effects of ACT on anxiety (SMD = -0.41 [95% CI of -0.93 - 0.11]), depression (SMD = -0.92 [95% CI of -1.91 - 0.06]), or ACT-targeted processes (SMD = -0.18 [95% CI of -0.62 - 0.25]). There was a small, nonsignificant effect on QoL, in favour of control conditions (SMD=0.39 [95% CI of -0.08 - 0.85]). Methodological quality of the studies was variable; all but one study had at least one high risk of bias.
CONCLUSIONS
Findings suggest a small effect of ACT on reducing stress for people with MS, but not reducing anxiety or depression, or improving quality of life. Due to small sample sizes and few studies within this area, generalisability of findings is limited. Future trials should be pay more attention to methodological rigour.
目的
综述接受与承诺疗法（ACT）对多发性硬化症（MS）患者生活质量和情绪的有效性的证据。
方法
对 PsycINFO、CINAHL、Embase、MEDLINE、Web of Science、Scopus 和 ContextualScience.org 进行了系统检索，检索时间截至 2022 年 1 月 13 日。还通过 ProQuest Dissertations and Theses 和 PROSPERO 检索了灰色文献。我们纳入了以英文发表的、评估 ACT 对 MS 患者有效性的随机对照试验（RCT）。我们对生活质量（QoL）、情绪（如焦虑、抑郁和压力）和 ACT 靶向过程的结果感兴趣。使用 Cochrane 偏倚风险工具 v2 评估方法学质量。在有可用数据的情况下，将提取的数据输入到荟萃分析中，以确定感兴趣结果的加权效应大小估计值。
结果
在 142 项研究中，有 6 项（191 名参与者）符合纳入标准。荟萃分析表明，ACT 对压力的影响具有统计学意义的小（SMD=-0.49 [95%置信区间：-0.89 至 -0.08]）。ACT 对焦虑（SMD=-0.41 [95%置信区间：-0.93 至 -0.11]）、抑郁（SMD=-0.92 [95%置信区间：-1.91 至 -0.06]）或 ACT 靶向过程（SMD=-0.18 [95%置信区间：-0.62 至 -0.05]）没有统计学意义的影响。控制条件对 QoL 的影响较小，但具有统计学意义（SMD=0.39 [95%置信区间：0.08 至 0.85]）。研究的方法学质量各不相同；除了一项研究外，其他研究均至少有一个高偏倚风险。
结论
研究结果表明，ACT 对降低 MS 患者的压力有较小的影响，但不能降低焦虑或抑郁，或改善生活质量。由于该领域的样本量较小且研究较少，因此结果的推广性有限。未来的试验应更加注重方法学的严谨性。
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