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认知行为干预对改善发育障碍儿童父母心理健康和幸福感的效果:系统评价和荟萃分析。

Cognitive-Based Interventions for Improving Psychological Health and Well-Being for Parents of Children with Developmental Disabilities: A Systematic Review and Meta-analysis.

机构信息

The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.

Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, China.

出版信息

J Autism Dev Disord. 2024 Sep;54(9):3316-3335. doi: 10.1007/s10803-023-06063-x. Epub 2023 Sep 5.

Abstract

This review aims to systematically summarize existing evidence to determine the effectiveness of cognitive-based interventions (CBIs) on psychological health and well-being among parents of children with developmental disabilities (DD). Six databases were searched to identify eligible randomized controlled trials (RCTs) from their inception to April 2023. The revised Cochrane Risk of Bias tool for RCTs was applied to assess the risk of bias and the certainty of evidence was evaluated using the Grading of Recommendation, Assessment, Development and Evaluation. Meta-analyses were conducted using a random-effects model. Twenty-five RCTs involving 1915 participants were identified. The results indicated that CBIs reduced parental stress levels (Hedges' g = - 0.69), depressive symptoms (g = - 0.95), anxiety levels (g = - 0.78), and parental distress (g = - 0.29), and improved parental well-being (g = 0.62) and parent‒child relationships (g = 0.43) postintervention compared with the active/inactive control groups. Subgroup analysis of the effectiveness of interventions using mindfulness-based interventions and cognitive behavioural therapy showed positive effects. The favourable intervention duration and participant targets were also identified in this review. Furthermore, the effects of CBIs were impacted by the different types of DD among the children. This review highlighted the positive effects of CBIs on parental stress levels, depressive symptoms, anxiety levels, parental distress levels, parental well-being levels, and parent‒child relationships. Future well-designed RCTs are needed to further investigate the effects of MBIs and CBT interventions on children with DD and their parents, as well as the factors and mechanisms of action affecting the efficacy of these interventions.

摘要

本综述旨在系统地总结现有证据,以确定认知行为干预(CBIs)对发育障碍儿童父母的心理健康和幸福感的有效性。从研究开始到 2023 年 4 月,我们在六个数据库中搜索了合格的随机对照试验(RCTs)。应用修订后的 Cochrane RCT 偏倚风险工具评估偏倚风险,使用推荐评估、制定与评价(GRADE)评估证据的确定性。使用随机效应模型进行荟萃分析。确定了 25 项涉及 1915 名参与者的 RCT。结果表明,CBI 可降低父母的压力水平(Hedges' g = -0.69)、抑郁症状(g = -0.95)、焦虑水平(g = -0.78)和父母困扰(g = -0.29),并改善父母的幸福感(g = 0.62)和亲子关系(g = 0.43),与积极/非活跃对照组相比,干预后。干预效果的亚组分析表明,正念为基础的干预和认知行为疗法具有积极的效果。本综述还确定了干预的有利干预持续时间和参与者目标。此外,CBI 的效果还受到儿童不同类型的发育障碍的影响。本综述强调了 CBI 对父母压力水平、抑郁症状、焦虑水平、父母困扰水平、父母幸福感水平和亲子关系的积极影响。需要进一步进行精心设计的 RCT 来研究 MBI 和 CBT 干预对发育障碍儿童及其父母的影响,以及影响这些干预效果的因素和作用机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beb4/11362495/b78edfbdbcca/10803_2023_6063_Fig1_HTML.jpg

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