School of Psychology, College Health and Life Sciences, Aston University, Birmingham, UK.
School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
Pediatr Allergy Immunol. 2024 Mar;35(3):e14108. doi: 10.1111/pai.14108.
This systematic review aimed to review the evidence for psychological support for children with food allergies and their families, identify effective psychological interventions, and highlight the support needs for this group. A systematic search was undertaken across six databases (up to October 2023). Articles were checked by three reviewers for inclusion. Study data were extracted, and quality was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis was undertaken. A total of 11 papers were included (n = 838 participants). Intervention types were based on cognitive behavioral therapy (CBT; n = 7); psycho-education (n = 1); peer mentoring (n = 1); self-regulation theory (n = 1); and coping (n = 1). Two interventions were for children only, three were for children and parents and six for parents only. Cognitive behavioral therapy-based interventions with highly anxious parents or children or those facilitated by a psychologist showed significant improvements with moderate-to-large effect sizes. The one self-help CBT-based online program showed no effects. Other intervention types reported mainly trends in improvement due to small sample sizes. Most interventions were aimed at supporting children or parents in day-to-day management of food allergy, measuring outcomes such as quality of life, self-efficacy, anxiety, worry, and depression. One intervention was designed to assist with oral immunotherapy outcomes. The majority of the studies had small sample sizes and were feasibility or proof-of-concept studies. Available research evidence points to effectiveness of facilitated CBT-based interventions for those that have high food allergy-related anxiety, but as many studies have small sample sizes and few report effect sizes, no firm conclusions can yet be drawn. A stepped care approach is likely to be useful for this population. Research using large interventional designs, particularly for children and adolescents, are needed.
本系统评价旨在综述针对食物过敏儿童及其家庭的心理支持的证据，确定有效的心理干预措施，并强调该群体的支持需求。系统检索了六个数据库（截至 2023 年 10 月）。由三位评审员检查文章是否符合纳入标准。提取研究数据，并使用混合方法评估工具评估质量。进行了叙述性综合。共纳入 11 篇论文（n=838 名参与者）。干预类型基于认知行为疗法（CBT；n=7）；心理教育（n=1）；同伴指导（n=1）；自我调节理论（n=1）；和应对（n=1）。有两种干预措施仅针对儿童，三种干预措施针对儿童和父母，六种干预措施仅针对父母。针对高度焦虑的父母或儿童或由心理学家促进的基于 CBT 的干预措施显示出显著改善，效果大小为中等至较大。唯一一种自我帮助的基于 CBT 的在线计划没有效果。由于样本量小，其他干预类型主要报告了改善的趋势。大多数干预措施旨在支持儿童或父母日常管理食物过敏，衡量生活质量、自我效能、焦虑、担忧和抑郁等结果。一种干预措施旨在协助口服免疫疗法的结果。大多数研究的样本量较小，且为可行性或概念验证研究。现有研究证据表明，针对那些具有高食物过敏相关焦虑的人，基于 CBT 的促进干预措施是有效的，但由于许多研究的样本量较小，且很少报告效果大小，因此目前还不能得出明确的结论。分步护理方法可能对该人群有用。需要使用大型干预性设计进行研究，特别是针对儿童和青少年的研究。
