Chan Mimi Wai Man, Lo Suzanne Hoi Shan, Sit Janet Wing Hung, Choi Kai Chow, Tao An
The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
Int J Nurs Stud Adv. 2023 Apr 2;5:100126. doi: 10.1016/j.ijnsa.2023.100126. eCollection 2023 Dec.
Stroke is the leading cause of disability worldwide. People with stroke face a variety of physical and psychosocial issues as a result of their disability. Visual arts-based interventions refer to providing participants with structured visual arts-based activities and non-judgemental and safe environments to improve their health-related outcomes. Recent evidence showed that visual arts-based interventions had the potential to promote the holistic well-being of people with stroke. However, evidence of the effects of visual arts-based interventions on physical and psychosocial outcomes of people with stroke is limited.
(1) To investigate the effects of visual arts-based interventions on physical and psychological outcomes in people with stroke and (2) to identify the effective regimen of visual arts-based interventions to improve physical and psychosocial outcomes in people with stroke.
A systematic review and meta-analysis.
Not applicable.
483 people with stroke were included in this review.
Fourteen English and five Chinese databases were searched from the date of their inception to February 2022 using keywords based on the Population, Intervention, Comparison, Outcome, and Study framework. Two reviewers independently assessed trial eligibility and risk of bias and extracted data. Methodological quality was assessed using the revised Cochrane risk of bias tool for randomised trials. Meta-analysis was conducted using Review Manager 5.4. Narrative synthesis was performed when meta-analysis was inappropriate to conduct. The Grading of Recommendations, Assessment, Development, and Evaluation Approach was used to assess the certainty of evidence.
Seven randomised controlled trials were included. A meta-analysis reported statistically significant effects of visual arts-based interventions on depressive symptoms (Standardized mean difference [SMD]: -1.14, 95% confidence interval [CI]: -1.67 to -0.61; three studies; moderate quality of evidence), activities of daily living (SMD: 0.96, 95% CI: 0.24 to 1.69; four studies; low quality of evidence), and upper limb function (SMD: 0.83, 95% CI: 0.42 to 1.24; two studies; low quality of evidence).
Visual arts-based interventions have favourable effects on depressive symptoms, activities of daily living, and upper limb function of people with stroke. However, the quality of evidence ranged from very low to moderate. Limited evidence suggested the effective regimen of visual arts-based interventions. Further rigorous randomised controlled trials should be developed to strengthen the relevant evidence.
Registered at the International Prospective Register of Systematic Reviews on 11 July 2022 (Number: CRD42022334646).
中风是全球致残的主要原因。中风患者由于残疾面临各种身体和心理社会问题。基于视觉艺术的干预措施是指为参与者提供结构化的基于视觉艺术的活动以及无评判且安全的环境，以改善他们与健康相关的结果。最近的证据表明，基于视觉艺术的干预措施有可能促进中风患者的整体幸福感。然而，基于视觉艺术的干预措施对中风患者身体和心理社会结果影响的证据有限。
（1）研究基于视觉艺术的干预措施对中风患者身体和心理结果的影响；（2）确定基于视觉艺术的干预措施的有效方案，以改善中风患者的身体和心理社会结果。
系统评价和荟萃分析。
不适用。
本评价纳入了483名中风患者。
从各数据库创建之日至2022年2月，使用基于人群、干预措施、对照、结局和研究框架的关键词，检索了14个英文数据库和5个中文数据库。两名评价者独立评估试验的纳入资格和偏倚风险并提取数据。使用修订后的Cochrane随机试验偏倚风险工具评估方法学质量。使用Review Manager 5.4进行荟萃分析。当不适合进行荟萃分析时，进行叙述性综合分析。采用推荐分级、评估、制定与评价方法来评估证据的确定性。
纳入了7项随机对照试验。一项荟萃分析报告，基于视觉艺术的干预措施对抑郁症状有统计学显著影响（标准化均数差[SMD]：-1.14，95%置信区间[CI]：-1.67至-0.61；3项研究；证据质量中等）、对日常生活活动有影响（SMD：0.96，95%CI：0.24至1.69；4项研究；证据质量低）以及对上肢功能有影响（SMD：0.83，95%CI：0.42至1.24；2项研究；证据质量低）。
基于视觉艺术的干预措施对中风患者的抑郁症状、日常生活活动和上肢功能有积极影响。然而，证据质量从极低到中等不等。有限的证据提示了基于视觉艺术的干预措施的有效方案。应开展进一步严格的随机对照试验以加强相关证据。
于2022年7月11日在国际系统评价前瞻性注册库注册（编号：CRD42022334646）。
