非药物干预对改善围产期丧亲父母心理健康及其他心理社会结局的有效性:一项系统评价与荟萃分析

Effectiveness of Nonpharmacological Interventions for Improving the Mental Health and Other Psychosocial Outcomes of Parents with Perinatal Loss: A Systematic Review and Meta-Analysis.

作者信息

Li Si Ni, Yang Li, Wang Qing Yu, Pan Si, Xiao Mei Hui, Xie Jiao

机构信息

Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.

The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong.

出版信息

Depress Anxiety. 2024 Aug 28;2024:2181544. doi: 10.1155/2024/2181544. eCollection 2024.

Abstract

The objective of this study was to assess the effectiveness of nonpharmacological interventions in enhancing the mental health and psychosocial outcomes of parents who have experienced perinatal loss, in comparison to active/inactive control groups. It also sought to identify the characteristics and components of effective interventions in the included studies. A comprehensive search was conducted across seven databases from January 2008 to December 2023. The analysis included randomized controlled trials (RCTs) published in English journals and dissertations that reported at least one mental health outcome postintervention for parents with perinatal loss. Twenty-one RCTs were included. The findings demonstrated significant improvements of nonpharmacological interventions in the grief, posttraumatic stress disorder, depression, anxiety, and perceived social support of parents with perinatal loss, with moderate-to-high certainty of evidence. Optimal characteristics of nonpharmacological interventions for parents with perinatal loss were identified to inform future studies, including the intervention approaches (cognitive-based interventions), delivery modalities (face-to-face), and formats (individual-based), and a recommended number of sessions of four or fewer. To validate these findings and explore the process of nonpharmacological interventions in improving health outcomes for parents with perinatal loss from diverse backgrounds, further rigorous RCTs with larger sample sizes and longer follow-up periods are required.

摘要

本研究的目的是评估与积极/非积极对照组相比,非药物干预措施在改善经历围产期丧亲之痛的父母的心理健康和社会心理结局方面的有效性。它还试图确定纳入研究中有效干预措施的特征和组成部分。2008年1月至2023年12月期间,对七个数据库进行了全面检索。分析纳入了发表在英文期刊和学位论文中的随机对照试验(RCT),这些研究报告了围产期丧亲父母干预后至少一项心理健康结局。共纳入21项RCT。研究结果表明,非药物干预措施能显著改善围产期丧亲父母的悲伤情绪、创伤后应激障碍、抑郁、焦虑以及感知到的社会支持,证据具有中到高度的确定性。确定了针对围产期丧亲父母的非药物干预措施的最佳特征,以为未来研究提供参考,包括干预方法(基于认知的干预)、提供方式(面对面)和形式(基于个体),以及建议疗程为四次或更少。为了验证这些发现,并探索非药物干预措施改善不同背景的围产期丧亲父母健康结局的过程,需要进行样本量更大、随访期更长的更严格的RCT。

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