Kelson Ellen, Dorstyn Diana
School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
J Autism Dev Disord. 2025 Jan;55(1):43-58. doi: 10.1007/s10803-023-06185-2. Epub 2023 Dec 9.
Caregivers of children with a neurodevelopmental disorder report increased mental health difficulties but also barriers to accessing professional support. Psychological interventions via telehealth offer an accessible method of service delivery for these families. This review is the first to quantitatively evaluate available telehealth trials designed to promote caregivers' mental health. The PubMed, PsycINFO, CINAHL, Embase and Cochrane databases (from inception until 20th May 2023) were searched for telehealth trials targeting caregiver mental health. Hedges' g effect sizes were calculated, and findings reported by symptom domain (depression, anxiety, stress, distress), telehealth format (individual vs. group), and modality (webpage, text-messaging, video). Reporting bias (QualSyst tool) and publication bias (Doi plot) were also assessed. Twelve independent studies (N = 769 caregivers), including eight controlled trials and four quasi-experimental (pre-post, single group) designs, were included. Most studies were of acceptable methodological quality. Evidence for improved mental health was found for telehealth (g range = 0.394-1.955), regardless of the method of delivery. The longevity of these effects could not, however, be determined. The present findings suggest that psychological interventions delivered by telephone and/or the internet can be used to effectively manage caregivers' mental health symptoms, although consideration must be given to an individual's treatment preferences and requirements. Further non-inferiority trials, with a diverse sample, can determine whether telehealth interventions provide a comparable alternative to face-to-face treatment. Protocol registration on Open Science Framework: https://osf.io/ctqne/ .
患有神经发育障碍儿童的照料者报告称，他们的心理健康问题增多，而且在获得专业支持方面存在障碍。通过远程医疗提供的心理干预为这些家庭提供了一种便捷的服务方式。本综述首次对旨在促进照料者心理健康的现有远程医疗试验进行了定量评估。我们在PubMed、PsycINFO、CINAHL、Embase和Cochrane数据库（从建库至2023年5月20日）中检索了针对照料者心理健康的远程医疗试验。计算了Hedges' g效应量，并按症状领域（抑郁、焦虑、压力、痛苦）、远程医疗形式（个体与团体）和模式（网页、短信、视频）报告了研究结果。还评估了报告偏倚（QualSyst工具）和发表偏倚（Doi图）。纳入了12项独立研究（N = 769名照料者），包括8项对照试验和4项准实验（前后对照、单组）设计。大多数研究的方法学质量可接受。无论采用何种提供方式，均发现远程医疗对改善心理健康有证据支持（g值范围 = 0.394 - 1.955）。然而，这些效果的持续时间无法确定。目前的研究结果表明，通过电话和/或互联网提供的心理干预可有效管理照料者的心理健康症状，不过必须考虑个体的治疗偏好和需求。进一步开展具有多样化样本的非劣效性试验，可确定远程医疗干预是否能提供与面对面治疗相当的替代方案。开放科学框架协议注册：https://osf.io/ctqne/ 。
