Llistosella Maria, Goni-Fuste Blanca, Martín-Delgado Leandra, Miranda-Mendizabal Andrea, Franch Martinez Berta, Pérez-Ventana Carmen, Castellvi Pere
Primary Health Care, Consorci Sanitari de Terrasa, Terrassa, Spain.
Department of Nursing, Universitat International de Catalunya, Sant Cugat del Vallés, Spain.
Front Psychol. 2023 Oct 6;14:1211113. doi: 10.3389/fpsyg.2023.1211113. eCollection 2023.
Resilience has been identified as a dynamic process that provides capabilities to face adversity. Considering the many protective factors involved in resilience and that the school is a key context to promote resilience, this review aimed to examine the effect of school-based interventions on resilience in adolescents.
A systematic literature review and meta-analysis were conducted in July 2021 on four databases. The risk of bias was assessed using the Cochrane risk of bias tool. Random-effects meta-analysis was used to obtain pooled estimates. Stratified analyses were done according to population type (general, at risk), intervention type, and follow-up assessments.
Of the 1,667 articles obtained, 27 were included in the systematic review and 16 in the meta-analysis. The random effects indicated a significant increase in resilience after the intervention [SMD = 0.58, 95% CI (0.29-0.87)]. Subgroup analysis showed effectiveness only in the population at risk [SMD = 1.28, 95% CI (0.53-2.03)] and early adolescence [SMD = 1.28, 95% CI (0.42-2.14), PI (-7.44 to 10.33)]. Multicomponent intervention [SMD = 1.45, 95% CI (0.11-2.80)] and Cognitive Behavioural Therapy (CBT) [SMD = 0.20, 95% CI (0.06-0.34)] demonstrated substantial effectiveness. Significant results were observed within 8-week follow-ups or less [SMD = 1.55, 95% CI (0.61-2.48)].
These findings provide evidence that multicomponent and CBT interventions increase resilience in early at-risk adolescents only in the short term. Developing resilience interventions is useful in schools exposed to unfavourable socioeconomic contexts. Furthermore, long-term interventions should be redesigned to improve their effectiveness.
PROSPERO [CRD42021277493].
复原力已被确认为一个动态过程，它提供面对逆境的能力。鉴于复原力涉及诸多保护因素，且学校是促进复原力的关键环境，本综述旨在探讨基于学校的干预措施对青少年复原力的影响。
2021年7月，我们在四个数据库上进行了系统的文献综述和荟萃分析。使用Cochrane偏倚风险工具评估偏倚风险。采用随机效应荟萃分析来获得合并估计值。根据人群类型（普通人群、高危人群）、干预类型和随访评估进行分层分析。
在获得的1667篇文章中，27篇被纳入系统综述，16篇被纳入荟萃分析。随机效应表明干预后复原力显著提高[标准化均数差（SMD）=0.58，95%置信区间（CI）（0.29 - 0.87）]。亚组分析显示仅在高危人群中有效[SMD = 1.28，95% CI（0.53 - 2.03）]以及在青春期早期有效[SMD = 1.28，95% CI（0.42 - 2.14），预测区间（PI）（-7.44至10.33）]。多成分干预[SMD = 1.45，95% CI（0.11 - 2.80）]和认知行为疗法（CBT）[SMD = 0.20，95% CI（0.06 - 0.34）]显示出显著效果。在8周及以内的随访中观察到显著结果[SMD = 1.55，95% CI（0.61 - 2.48）]。
这些发现提供了证据，表明多成分和CBT干预仅在短期内提高早期高危青少年的复原力。在面临不利社会经济环境的学校中开展复原力干预是有用的。此外，应重新设计长期干预措施以提高其有效性。
PROSPERO [CRD42021277493]
