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基于同情的干预对围手术期焦虑和抑郁的影响:系统评价和荟萃分析。

The impact of compassion-based interventions on perioperative anxiety and depression: A systematic review and meta-analysis.

机构信息

Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.

Medical College of Wisconsin, Milwaukee, WI, USA.

出版信息

J Affect Disord. 2024 Nov 15;365:476-491. doi: 10.1016/j.jad.2024.08.110. Epub 2024 Aug 23.

Abstract

BACKGROUND

The perioperative period can be a stressful time for many patients. Concerns for the procedure or fearing potential complications contribute to perioperative anxiety and depression, which significantly impact patient wellbeing and recovery. Understanding the psychological impact of the perioperative period can inform individualized care focused on each patient's unique stressors. Compassion-based interventions are limited but have shown benefits in non-surgical healthcare settings, and can provide support by prioritizing empathy and understanding in the perioperative period. This review evaluates the impact of compassion-based interventions on anxiety and depression among adult surgical patients.

METHODS

A systematic review of 25 randomized controlled trials was conducted with a meta-analysis of 14 studies for anxiety and 9 studies for depression that provided sufficient information.

RESULTS

The included studies tested compassion-based interventions that focused on enhanced communication, emotional support, and individualized attention from healthcare professionals. In 72 % of the studies, the interventions decreased anxiety and depression, compared to control groups. These interventions improved health-related outcomes such patient satisfaction and postoperative complications. The meta-analysis indicated a large effect of the compassion-based interventions for anxiety (g = -0.95) and depressive symptoms (g = -0.82). The findings were consistent among various surgeries and patient populations.

LIMITATIONS

Many of the included studies lacked clarity in their methods and only 14 studies provided sufficient information for the meta-analysis.

CONCLUSIONS

Given the growing evidence suggesting that compassion-based psychological interventions are feasible and applicable in the perioperative setting, their inclusion in routine care could reduce depression and anxiety around surgery and improve patient outcomes and experiences.

摘要

背景

围手术期对许多患者来说都是一个压力较大的时期。对手术过程的担忧或对潜在并发症的恐惧导致围手术期焦虑和抑郁,这对患者的幸福感和康复有重大影响。了解围手术期的心理影响可以为个性化护理提供信息,重点关注每位患者的独特压力源。基于同情的干预措施有限,但已在非手术医疗保健环境中显示出益处,并可以通过在围手术期优先考虑同理心和理解来提供支持。本综述评估了基于同情的干预措施对成年手术患者焦虑和抑郁的影响。

方法

对 25 项随机对照试验进行了系统综述,对提供了足够信息的 14 项焦虑研究和 9 项抑郁研究进行了荟萃分析。

结果

纳入的研究测试了基于同情的干预措施,这些干预措施侧重于增强医护人员的沟通、情感支持和个性化关注。在 72%的研究中,与对照组相比,干预措施降低了焦虑和抑郁。这些干预措施改善了与健康相关的结果,如患者满意度和术后并发症。荟萃分析表明,基于同情的干预措施对焦虑(g=-0.95)和抑郁症状(g=-0.82)有很大的影响。研究结果在各种手术和患者群体中是一致的。

局限性

纳入的许多研究方法不够清晰,只有 14 项研究提供了足够的信息进行荟萃分析。

结论

鉴于越来越多的证据表明基于同情的心理干预在围手术期是可行且适用的,将其纳入常规护理可以减轻手术前后的抑郁和焦虑,改善患者的结局和体验。

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