Mei Xiaoxiao, Li Yan, Yeung Wing Fai, Hu Yule, Li Jiaying, Li Mengqi, Yorke Janelle
School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China.
J Nurs Manag. 2025 Jul 29;2025:9923240. doi: 10.1155/jonm/9923240. eCollection 2025.
Rheumatic diseases are a group of inflammatory conditions that significantly impact physical and mental health. Ecological momentary interventions have shown promising effects among individuals with rheumatic diseases as they can deliver the most appropriate type and intensity of intervention tailored to their needs in real time, but their effectiveness has not been systematically reviewed and examined. To examine the effectiveness of ecological momentary interventions in reducing pain, improving mental health, and enhancing quality of life in individuals with rheumatic diseases. Systematic review and meta-analysis. A literature search was conducted in nine electronic databases from inception to April 2024. Randomized controlled trials (RCTs) examining the impact of ecological momentary interventions on pain, mental health, and/or quality of life in rheumatic disease populations were included. Two authors independently screened studies, extracted data, and assessed the risk of bias using Cochrane's bias risk tool for randomized trials (ROB 2). The intervention effect was estimated by calculating the standardized mean difference (SMD) and 95% confidence interval (CI) with R 4.3.3 software. The certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Sixteen RCTs with 1869 participants were included. Ecological momentary interventions significantly reduced pain (SMD = 0.18, 95% CI: 0.04-0.33) and marginally improved quality of life (SMD = 0.29, 95% CI: -0.01-0.60) versus controls. Subgroup analyses revealed greater effects for ecological momentary interventions with daily reminders on pain reduction (SMD = 0.21, 95% CI: 0.06-0.36) and quality-of-life improvement (SMD = 0.45, 95% CI: 0.02-0.88), as well as for ecological momentary interventions involving human contact on pain (SMD = 0.31, 95% CI: 0.10-0.52) and quality of life (SMD = 0.60, 95% CI: 0.25-0.95). However, both the primary analysis and subgroup analyses showed that ecological momentary interventions did not significantly improve anxiety and depression. Ecological momentary interventions could alleviate pain and enhance quality of life in rheumatic disease populations, but had no significant effect on improving mental health. Future research should explore optimizing ecological momentary intervention design and implementation and further examine its effects on mental health outcomes in this population.
风湿性疾病是一组炎症性疾病，对身心健康有重大影响。生态瞬时干预在风湿性疾病患者中显示出有前景的效果，因为它们可以实时提供最适合其需求的干预类型和强度，但其有效性尚未得到系统的综述和检验。为了检验生态瞬时干预在减轻风湿性疾病患者疼痛、改善心理健康和提高生活质量方面的有效性。进行系统综述和荟萃分析。从数据库建立到2024年4月在九个电子数据库中进行文献检索。纳入考察生态瞬时干预对风湿性疾病人群疼痛、心理健康和/或生活质量影响的随机对照试验（RCT）。两位作者独立筛选研究、提取数据，并使用Cochrane随机试验偏倚风险工具（ROB 2）评估偏倚风险。使用R 4.3.3软件计算标准化均数差（SMD）和95%置信区间（CI）来估计干预效果。使用推荐分级、评估、制定和评价（GRADE）方法评估证据的确定性。纳入了16项RCT，共1869名参与者。与对照组相比，生态瞬时干预显著减轻了疼痛（SMD = 0.18，95%CI：0.04 - 0.33），并略微改善了生活质量（SMD = 0.29，95%CI： - 0.01 - 0.60）。亚组分析显示，每日提醒的生态瞬时干预在减轻疼痛（SMD = 0.21，95%CI：0.06 - 0.36）和改善生活质量（SMD = 0.45，95%CI：0.02 - 0.88）方面效果更大，涉及人际接触的生态瞬时干预在疼痛（SMD = 0.31，95%CI：0.10 - 0.52）和生活质量（SMD = 0.60，95%CI：0.25 - 0.95）方面效果也更大。然而，主要分析和亚组分析均显示，生态瞬时干预并未显著改善焦虑和抑郁。生态瞬时干预可以减轻风湿性疾病人群的疼痛并提高生活质量，但对改善心理健康没有显著效果。未来的研究应探索优化生态瞬时干预的设计和实施，并进一步考察其对该人群心理健康结局的影响。
