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教育对患有神经系统疾病的成年人疲劳有何影响?一项系统评价和荟萃分析。

What is the effect of education on fatigue in adults with neurological conditions? A systematic review and meta-analysis.

作者信息

Delbridge Alex, Howlett Owen, English Coralie, Simpson Dawn B

机构信息

Bendigo Health Care Group, Bendigo, Victoria, Australia.

Outpatient Rehabilitation Services, Bendigo Health Care Group, Bendigo, Victoria, Australia.

出版信息

Clin Rehabil. 2025 Aug;39(8):1019-1033. doi: 10.1177/02692155251351510. Epub 2025 Jun 22.

Abstract

ObjectiveTo determine the effect of education programs on fatigue outcomes in people with neurological conditions.Data sourcesMEDLINE, CINAHL, EMBASE, PEDRO until May 2025, according to PRISMA guidelines.Review methodsSystematic review with meta-analysis of randomised controlled trials comparing education versus no education/other intervention on the outcome of fatigue for people with neurological conditions. Methodological quality and risk of bias were assessed using the Cochrane Risk of Bias Tool. Pooled effects were calculated using standard mean difference (SMD).ResultsWe included 19 clinical trials of education for fatigue ( = 1970 participants) in five different neurological conditions. Education duration ranged from 4 to 12 weeks, 79% ( = 15) of trials included people with multiple sclerosis and 18% ( = 3) included people with stroke. Most education (11 trials, 58%) was delivered in a group setting. Education reduced fatigue compared with usual care by a SMD -0.28, 95% CI [-0.45 to -0.11]. Greater benefits for fatigue were observed when education was delivered one-to-one (SMD -0.44, 95% CI [-0.77 to -0.12]) than in group sessions (SMD -0.17, 95% CI [-0.36 to 0.01]). Mode of delivery (in-person versus telehealth) did not appear to influence the effect of education for fatigue.ConclusionsFatigue education programs may improve fatigue for people with neurological conditions. One-to-one delivered sessions may have greater benefits than group programs and remote delivery could improve accessibility for people living in regional and rural locations.

摘要

目的

确定教育项目对神经系统疾病患者疲劳结局的影响。

数据来源

截至2025年5月,根据PRISMA指南检索MEDLINE、CINAHL、EMBASE、PEDRO数据库。

综述方法

对随机对照试验进行系统综述和荟萃分析,比较教育干预与无教育干预/其他干预对神经系统疾病患者疲劳结局的影响。使用Cochrane偏倚风险工具评估方法学质量和偏倚风险。采用标准化均数差(SMD)计算合并效应。

结果

我们纳入了针对五种不同神经系统疾病的19项疲劳教育临床试验(n = 1970名参与者)。教育时长从4周到12周不等,79%(n = 15)的试验纳入了多发性硬化症患者,18%(n = 3)纳入了中风患者。大多数教育干预(11项试验,58%)采用小组形式进行。与常规护理相比,教育干预使疲劳程度降低,标准化均数差为-0.28,95%置信区间为[-0.45至-0.11]。一对一教育干预(标准化均数差为-0.44,95%置信区间为[-0.77至-0.12])比小组教育干预(标准化均数差为-0.17,95%置信区间为[-0.36至0.01])对疲劳的改善效果更显著。教育干预的实施方式(面对面与远程医疗)似乎并未影响对疲劳的教育效果。

结论

疲劳教育项目可能改善神经系统疾病患者的疲劳状况。一对一授课可能比小组项目带来更大益处,远程授课可提高偏远地区居民的可及性。

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