非药物干预对结肠镜检查患者焦虑的影响：一项随机对照试验的网状Meta分析
Effects of non-pharmacological interventions on anxiety in patients undergoing colonoscopy: A network meta-analysis of randomized controlled trials.
作者信息
Chen Yun-Shan, Feng Ge-Hui, Yue Qian-Qian, Wang Yi-Fei, Liu Min, Zhao Ke-Hao, Tang Tian, Huang Mao-Ting, Yi Wen-Ting, Yan Hui-Ling, Yan Jia-Hui, Zeng Ying
机构信息
Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China.
Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China.; Hunan Engineering Research Center for Early Diagnosis and Treatment of Liver Cancer, Cancer Research Institute, Hengyang Medical School, University of South China; Hunan Province Key Laboratory of Tumor Cellular & Molecular Pathology, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, China..
出版信息
J Psychosom Res. 2025 Apr;191:112065. doi: 10.1016/j.jpsychores.2025.112065. Epub 2025 Feb 19.
BACKGROUND
Anxiety is a common and significant problem in patients who need to undergo colonoscopy. However, the question of which non-pharmacological intervention is the best strategy to reduce anxiety in patients undergoing colonoscopy remains unanswered.
OBJECTIVES
To evaluate and rank the effectiveness of various non-pharmacological interventions for reducing anxiety in patients undergoing colonoscopy in order to identify the most effective strategies.
METHODS
We searched PubMed, Cochrane Library, Embase, Web of Science, and Medline for randomized controlled trials published from the database construction to March 2024. The primary outcome was the difference between pre- and post-intervention anxiety means. A network meta-analysis was conducted utilizing the "gemtc" package based on R4.3.0.
RESULTS
The analysis encompassed 24 randomized controlled trials, incorporating 2525 participants and evaluating 9 non-pharmacological interventions. All non-pharmacological interventions reduced anxiety in patients undergoing colonoscopy compared to standard care, with music intervention (SMD = -0.52, 95 %CI (-0.84,-0.20)), audiovisual distraction (SMD = -0.54, 95 %CI(-0.96,-0.12)), video information (SMD = -1.47, 95 %CI(-2.03,-0.90)), individual education (SMD = -1.72, 95 %CI(-2.76,-0.70)), and electroacupuncture (SMD = -1.12, 95 %CI(-2.10,-0.13)) having statistically significant effects. SUCRA ranking identified the priority of individual education (SUCRA: 92.5 %) and video information (SUCRA: 87.7 %). Meta-regression and sensitivity analysis further demonstrated the stability of the evidence. The certainty of the evidence was mostly rated as medium to low.
CONCLUSION
This review highlights the superior effects of individual education and video information in reducing anxiety in patients undergoing colonoscopy. The findings of our review could provide clinical decision-makers and healthcare practitioners, such as doctors and nurses, with evidence-based practices for selecting interventions to reduce anxiety in patients undergoing colonoscopy.
背景
焦虑是需要接受结肠镜检查的患者中常见且严重的问题。然而，哪种非药物干预是减轻结肠镜检查患者焦虑的最佳策略这一问题仍未得到解答。
目的
评估并排序各种非药物干预对减轻结肠镜检查患者焦虑的有效性，以确定最有效的策略。
方法
我们在PubMed、Cochrane图书馆、Embase、科学网和Medline中检索了从数据库建立至2024年3月发表的随机对照试验。主要结局是干预前后焦虑均值的差异。基于R4.3.0使用“gemtc”软件包进行网络荟萃分析。
结果
该分析纳入了24项随机对照试验，涉及2525名参与者，评估了9种非药物干预措施。与标准护理相比，所有非药物干预措施均降低了结肠镜检查患者的焦虑，音乐干预（标准化均值差= -0.52，95%置信区间（-0.84，-0.20））、视听分散注意力（标准化均值差= -0.54，95%置信区间（-0.96，-0.12））、视频信息（标准化均值差= -1.47，95%置信区间（-2.03，-0.90））、个体教育（标准化均值差= -1.72，95%置信区间（-2.76，-0.70））和电针（标准化均值差= -1.12，95%置信区间（-2.10，-0.13））具有统计学显著效果。SUCRA排序确定了个体教育（SUCRA：92.5%）和视频信息（SUCRA：87.7%）的优先性。Meta回归和敏感性分析进一步证明了证据的稳定性。证据的确定性大多被评为中到低。
结论
本综述强调了个体教育和视频信息在减轻结肠镜检查患者焦虑方面的卓越效果。我们综述的结果可为临床决策者和医疗保健从业者（如医生和护士）提供基于证据的实践方法，用于选择干预措施以减轻结肠镜检查患者的焦虑。
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