心理社会干预对小儿脊柱侧弯患者的有效性：一项系统评价。
Effectiveness of psychosocial interventions for pediatric patients with scoliosis: a systematic review.
作者信息
van Niekerk Maike, Richey Ann, Vorhies John, Wong Connie, Tileston Kali
机构信息
Pediatric Orthopaedic Surgery, Stanford University, Stanford, California, USA.
Lane Medical Library, Stanford University, Stanford, California, USA.
出版信息
World J Pediatr Surg. 2023 Mar 7;6(2):e000513. doi: 10.1136/wjps-2022-000513. eCollection 2023.
BACKGROUND
Pediatric patients affected by scoliosis have complex psychological and social care needs, and may benefit from psychosocial interventions. We therefore aimed to summarize evidence of the efficacy of psychosocial interventions for this patient population.
METHODS
Literature was identified by searching Medline, PsycINFO, Embase, EBSCO Cumulated Index to Nursing and Allied Health Literature (CINAHL), and Cochrane Central Register of Controlled Trials (CENTRAL) from database inception to 20 March 2022. Articles that evaluated the effectiveness of psychosocial interventions for pediatric patients diagnosed with scoliosis and reported at least one quantitative outcome were included. Article eligibility, data extraction, and quality assessment (using the Cochrane Collaboration's Risk of Bias Tool and Methodological Index for Non-Randomized Studies) were performed by two independent researchers. Findings are presented using narrative synthesis.
RESULTS
We identified ten studies, all of which focused on adolescent idiopathic scoliosis. Studies included a total of 1007 participants, most of whom were female. Three studies focused on patients undergoing bracing, six on patients undergoing spinal surgery, and one on patients broadly. Brace compliance monitoring and counseling were found to significantly improve brace compliance quality and quantity. Proactive mental healthcare delivery by nurses after spinal surgery was similarly found to improve outcomes. Several studies examined the efficacy of brief educational interventions; most did not report clear evidence of their efficacy. The methodological quality of studies was often unclear due to limitations in articles' reporting quality.
CONCLUSIONS
Research on the efficacy of psychosocial interventions for pediatric patients with scoliosis is limited, with interventions involving frequent patient-provider interactions showing the most promise. Future clinical and research efforts should focus on developing and testing psychosocial interventions for this patient population, with emphasis on multidisciplinary teams delivering holistic care.
TRIAL REGISTRATION NUMBER
PROSPERO number CRD42022326957.
背景
受脊柱侧弯影响的儿科患者有复杂的心理和社会护理需求，可能会从心理社会干预中受益。因此，我们旨在总结针对这一患者群体的心理社会干预效果的证据。
方法
通过检索Medline、PsycINFO、Embase、EBSCO护理及相关健康文献累积索引（CINAHL）和Cochrane对照试验中央注册库（CENTRAL），从数据库建立至2022年3月20日来识别文献。纳入评估心理社会干预对诊断为脊柱侧弯的儿科患者有效性并报告至少一项定量结果的文章。文章的合格性、数据提取和质量评估（使用Cochrane协作网的偏倚风险工具和非随机研究的方法学指数）由两名独立研究人员进行。研究结果采用叙述性综合呈现。
结果
我们识别出10项研究，所有研究均聚焦于青少年特发性脊柱侧弯。研究共纳入1007名参与者，其中大多数为女性。3项研究聚焦于接受支具治疗的患者，6项聚焦于接受脊柱手术的患者，1项则广泛涉及各类患者。发现支具依从性监测和咨询可显著提高支具依从性的质量和数量。同样发现脊柱手术后护士提供的积极心理保健可改善结局。多项研究考察了简短教育干预的效果；大多数研究未报告其有效性的确切证据。由于文章报告质量的限制，研究的方法学质量往往不明确。
结论
关于心理社会干预对脊柱侧弯儿科患者有效性的研究有限，涉及患者与提供者频繁互动的干预显示出最大前景。未来的临床和研究工作应侧重于为这一患者群体开发和测试心理社会干预措施，重点是多学科团队提供全面护理。
试验注册号
PROSPERO编号CRD42022326957。
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