Rask Mette Trøllund, Frostholm Lisbeth, Hansen Sofie Høeg, Petersen Marie Weinreich, Ørnbøl Eva, Rosendal Marianne
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus N, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark.
Health Psychol Rev. 2024 Mar;18(1):75-116. doi: 10.1080/17437199.2022.2163917. Epub 2023 Jan 24.
Persistent physical symptoms (PPS) remain a challenge in the healthcare system due to time-constrained consultations, uncertainty and limited specialised care capacity. Self-help interventions may be a cost-effective way to widen the access to treatment. As a foundation for future interventions, we aimed to describe intervention components and their potential effects in self-help interventions for PPS. A systematic literature search was made in PubMed, EMBASE, PsycINFO and CENTRAL. Fifty-one randomised controlled trials were included. Interventions were coded for effect on outcomes (standardised mean difference ≥0.2) related to symptom burden, anxiety, depression, quality of life, healthcare utilisation and sickness absence. The Behaviour Change Technique (BCT) Taxonomy v1 was used to code intervention components. An index of potential was calculated for each BCT within an outcome category. Each BCT was assessed as 'potentially effective' or 'not effective' based on a two-sided test for binomial random variables. Sixteen BCTs showed potential effect as treatment components. These BCTs represented the themes: goals and planning, feedback and monitoring, shaping knowledge, natural consequences, comparison of behaviour, associations, repetition and substitution, regulation, antecedents and identity. The results suggest that specific BCTs should be included in new PPS self-help interventions aiming to improve the patients' physical and mental health.
由于会诊时间有限、存在不确定性以及专业护理能力有限，持续性身体症状（PPS）仍是医疗系统面临的一项挑战。自助干预可能是一种扩大治疗可及性的具有成本效益的方式。作为未来干预措施的基础，我们旨在描述PPS自助干预措施的干预组成部分及其潜在效果。我们在PubMed、EMBASE、PsycINFO和CENTRAL中进行了系统的文献检索。纳入了51项随机对照试验。对干预措施针对与症状负担、焦虑、抑郁、生活质量、医疗利用和病假相关的结局（标准化均数差≥0.2）的效果进行编码。使用行为改变技术（BCT）分类法v1对干预组成部分进行编码。计算每个结局类别内每个BCT的潜在指数。基于对二项随机变量的双侧检验，将每个BCT评估为“可能有效”或“无效”。16个BCT显示出作为治疗组成部分的潜在效果。这些BCT代表了以下主题：目标与规划、反馈与监测、塑造知识、自然结果、行为比较、关联、重复与替代、调节、先行因素与身份认同。结果表明，旨在改善患者身心健康的新的PPS自助干预措施应纳入特定的BCT。
