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心理社会干预对血液透析患者抑郁、焦虑和生活质量的影响:系统评价和荟萃分析。

The effect of psychosocial interventions on depression, anxiety, and quality of life in hemodialysis patients: a systematic review and a meta-analysis.

机构信息

EngageMinds HUB-Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy.

Department of Psychology, Università Cattolica del Sacro Cuore, L.go Gemelli 1, 20123, Milan, Italy.

出版信息

Int Urol Nephrol. 2023 Apr;55(4):897-912. doi: 10.1007/s11255-022-03374-3. Epub 2022 Oct 1.

Abstract

PURPOSE

Hemodialysis has become a standard therapy for adults with end-stage renal diseases. Adults undergoing hemodialysis have to cope with unique psychological issues that make their care journey particularly fatiguing. In this systematic review and meta-analysis, we aimed to summarize and evaluate the effects of psychosocial interventions on the reduction of anxiety and depression in adults with HDs.

METHODS

We included randomized controlled trials and quasi-experimental studies that measure change in depression, anxiety, and quality of life.

RESULTS

We identify three categories of psychosocial interventions delivered to adults undergoing hemodialysis. Based on our analysis, there was a medium effect of psychosocial intervention on depression (SMD - 0.85, 95%CI - 1.17; - 0.52, I = 80%, p < 0.01) and anxiety (SMD - 0.99, 95%CI - 1.65; - 0.33, I = 88%, p < 0.01) in adults undergoing hemodialysis.

CONCLUSIONS

Psychosocial interventions, such as psychological support or relaxation-based therapy, seems all to reduce depression and anxiety in adults undergoing HD. Preliminary evidence suggests that there may be a benefit of psychosocial interventions on the quality of life for adults undergoing HD.

摘要

目的

血液透析已成为治疗终末期肾病成人患者的标准疗法。接受血液透析的成年人必须应对独特的心理问题,这使得他们的治疗过程特别疲惫。在这项系统评价和荟萃分析中,我们旨在总结和评估心理社会干预对降低血液透析患者焦虑和抑郁的效果。

方法

我们纳入了测量抑郁、焦虑和生活质量变化的随机对照试验和准实验研究。

结果

我们确定了三种针对接受血液透析的成年人的心理社会干预措施。根据我们的分析,心理社会干预对接受血液透析的成年人的抑郁(SMD - 0.85,95%CI - 1.17;-0.52,I=80%,p<0.01)和焦虑(SMD - 0.99,95%CI - 1.65;-0.33,I=88%,p<0.01)有中等程度的影响。

结论

心理社会干预措施,如心理支持或基于放松的治疗,似乎可以降低接受血液透析的成年人的抑郁和焦虑。初步证据表明,心理社会干预可能对接受血液透析的成年人的生活质量有一定的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd47/10030538/6e51467ab115/11255_2022_3374_Fig1_HTML.jpg

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