School of Nursing, Faculty of Applied Science, The University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada.
The Aga Khan University, School of Nursing and Midwifery, Karachi, Pakistan.
J Psychosom Res. 2023 Sep;172:111416. doi: 10.1016/j.jpsychores.2023.111416. Epub 2023 Jun 19.
Mental health issues are closely associated with symptoms and outcomes of cardiovascular diseases (CVDs). The magnitude of this problem is alarmingly high in low and middle-income countries (LMICs). This systematic review and meta-analysis aimed to examine the effectiveness of psychosocial interventions on mental health outcomes among patients with CVDs living in LMICs.
This review includes Randomized controlled trials (RCTs) and quasi-experimental studies conducted on adult patients who had a CVD and/or hypertension and located in LMICs. Studies published in English between 2010 and March, 2021 and which primarily reported mental health outcomes of resilience, self-efficacy, Quality of life (QoL), depression and anxiety were included. Studies were screened, extracted and critically appraised by two independent reviewers. Meta-analysis was conducted for RCTs and narrative summaries were conducted for all other studies. PRISMA guidelines were followed for reporting review methods and findings.
109 studies included in this review reported educational, nursing, behavioral and psychological, spiritual, relaxation, and mindfulness interventions provided by multidisciplinary teams. 14 studies reported self-efficacy, 70 reported QoL, 62 reported one or both of anxiety and depression, and no study was found that reported resilience as an outcome in this population. Pooled analysis showed improvements in self-efficacy and QoL outcomes. The majority of studies showed improvement in outcomes, though the quality of the included studies varied.
Patients with CVDs in LMICs may experience improved mental health through the use of diverse psychosocial interventions. Evaluations are needed to investigate whether the impact of interventions on mental health are sustained over time.
心理健康问题与心血管疾病（CVD）的症状和结果密切相关。在中低收入国家（LMICs），这个问题的严重程度令人震惊。本系统评价和荟萃分析旨在研究心理社会干预对生活在 LMICs 的 CVD 患者心理健康结果的有效性。
本综述包括在 2010 年至 2021 年 3 月期间，在中低收入国家进行的针对患有 CVD 和/或高血压的成年患者的随机对照试验（RCTs）和准实验研究。纳入的研究发表于英文期刊，主要报告了韧性、自我效能、生活质量（QoL）、抑郁和焦虑等心理健康结果。研究由两名独立的审查员进行筛选、提取和批判性评价。对 RCTs 进行荟萃分析，对所有其他研究进行叙述性总结。报告综述方法和结果时遵循 PRISMA 指南。
本综述共纳入了 109 项研究，这些研究报告了由多学科团队提供的教育、护理、行为和心理、精神、放松和正念干预。14 项研究报告了自我效能，70 项研究报告了生活质量，62 项研究报告了焦虑和抑郁中的一项或两项，没有研究报告韧性是这一人群的结果。汇总分析显示自我效能和生活质量结果有所改善。大多数研究表明结果有所改善，但纳入研究的质量存在差异。
在 LMICs，通过使用多种心理社会干预，CVD 患者的心理健康可能会得到改善。需要评估干预对心理健康的影响是否随着时间的推移而持续。
