Chair Sek Ying, Law Bernard Man Hin, Chan Aileen Wai Kiu, Gao Ruitong
The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China.
BMC Nurs. 2025 Feb 14;24(1):174. doi: 10.1186/s12912-025-02792-9.
Self-esteem is a psychological outcome that is positively related to mental and psychological health, one of the most important elements in nursing. Developing strategies for self-esteem promotion is therefore of great importance in nursing practice. Previous reviews suggested that exercise interventions such as Tai Chi practice may confer both mental and physical benefits in humans, but reviews on the effect of Tai Chi exercise on self-esteem of adults are lacking. Thus, this systematic review and meta-analysis was conducted to evaluate the effectiveness of Tai Chi interventions in promoting self-esteem among adults.
We included randomized controlled trials that investigated Tai Chi interventions in adults, where self-esteem and/or self-confidence were reported as outcomes. The literature search was conducted in ten electronic databases. Two independent reviewers performed abstract and full-text screening using Covidence. These reviewers also independently extracted data from the included studies, and conducted critical appraisal of their methodological quality, using the revised Cochrane risk-of-bias tool for randomized trials (RoB2).
Eleven studies were included in the review, of which all were rated as having high risk of bias or some concerns in their methodological quality. Our meta-analysis demonstrated that Tai Chi intervention can significantly improve self-esteem among adults, where the post-intervention self-esteem score was higher among the intervention participants compared to the controls (standardized mean difference: 0.46; 95% CI: 0.18-0.74; p = 0.001). Sensitivity analyses by excluding studies not reporting data using means and standard deviations revealed similar findings. One study also showed a positive effect of Tai Chi intervention on self-confidence perception.
Tai Chi interventions have a moderately positive effect on self-esteem among adults. Tai Chi exercise classes could be a potential strategy to implement within communities, especially among individuals in higher need to improve their self-esteem such as older adults and patients having chronic illnesses that have detrimental effects on their psychological well-being. However, given the high risk of bias in most studies, caution is advised before recommending widespread implementation. Further high-quality research, including qualitative studies exploring how Tai Chi can improve self-esteem, is needed to strengthen the evidence base.
自尊是一种与心理和精神健康呈正相关的心理结果，是护理中最重要的因素之一。因此，制定提升自尊的策略在护理实践中至关重要。以往的综述表明，诸如太极拳练习等运动干预可能对人类的心理和身体都有益处，但缺乏关于太极拳运动对成年人自尊影响的综述。因此，进行了这项系统综述和荟萃分析，以评估太极拳干预对促进成年人自尊的有效性。
我们纳入了调查成年人太极拳干预的随机对照试验，其中自尊和/或自信被报告为结果。在十个电子数据库中进行了文献检索。两名独立评审员使用Covidence进行摘要和全文筛选。这些评审员还独立从纳入的研究中提取数据，并使用修订后的Cochrane随机试验偏倚风险工具（RoB2）对其方法学质量进行严格评估。
该综述纳入了11项研究，所有这些研究在方法学质量上均被评为具有高偏倚风险或存在一些问题。我们的荟萃分析表明，太极拳干预可以显著提高成年人的自尊，干预组参与者干预后的自尊得分高于对照组（标准化平均差：0.46；95%置信区间：0.18 - 0.74；p = 0.001）。通过排除未使用均值和标准差报告数据的研究进行的敏感性分析得出了类似的结果。一项研究还表明太极拳干预对自信感知有积极影响。
太极拳干预对成年人自尊有中度积极影响。太极拳运动课程可能是在社区内实施的一种潜在策略，特别是在那些更需要提高自尊的人群中，如老年人和患有对其心理健康有不利影响的慢性病患者。然而，鉴于大多数研究存在高偏倚风险，在建议广泛实施之前需谨慎。需要进一步的高质量研究，包括探索太极拳如何提高自尊的定性研究，以加强证据基础。
