延续护理对COPD患者自我效能和焦虑抑郁的影响系统评价和Meta分析

Effects of Extended Care on Self-efficacy, Anxiety and Depression for Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis

目的系统评价延续护理对COPD患者自我效能、焦虑及抑郁的影响。方法检索Cochrane图书馆临床对照试验资料库、Medline、Embase、AMED、CINAHL、中国生物医学文献数据库、中国知网、维普和万方数据库。收集所有延续护理对COPD患者自我效能、焦虑及抑郁影响的随机对照试验及半随机对照试验。由2名研究者按照纳入和排除标准,筛选文献并提取资料,参考Cochrane Handbook的质量评价标准进行质量评价,并用Rev Man 5.3进行Meta分析。结果共纳入9项研究,共844例患者。(1)Meta分析结果显示:与常规出院护理比较,干预1个月、3个月、6个月时,延续护理能提高COPD患者慢性阻塞性肺疾病自我效能量表评分;干预3个月时,延续护理能降低COPD患者焦虑、抑郁评分。(2)描述性分析结果显示:干预3个月时,延续护理能提高COPD患者一般自我效能量表评分;干预6个月时,延续护理能降低COPD患者抑郁评分。结论与常规出院护理相比,延续护理在干预1个月、3个月、6个月时,能提高COPD患者自我效能水平;干预3个月时,能减轻COPD患者焦虑及抑郁程度。由于纳入研究文献质量一般,结论尚需大量高质量的研究予以证实。

Objective To assess the effect of extended care on self-efficacy, anxiety and depression on COPD（chronic obstructive pulmonary disease） patients. Methods We searched the Cochrane Central Register of Controlled Trials, Medline, Embase, AMED,CINAHL, CMB, CNKI, VIP and Wanfang database to collect all randomized controlled Trials（RCTs） or quasi-randomized control trials（quasi-RCTs） in which the influence of extended care on the self-efficacy, anxiety or depression of COPD patients was explored.The studies were selected according to the inclusion and exclusion criteria by two reviewers, and the quality of included studies was evaluated through Cochrane Handbook and meta-analysis by The Cochrane Collaboration ＇s Rev Man 5.3. Results Nine RCTs involving 844 patients were included. Meta-analysis showed that compared with conventional nursing, extended care was effective in increasing the score of CSES（Chronic obstructive pulmonary disease self-efficacy scale）, and in decreasing the score of SAS（Self-Rating Anxiety Scale） and the score of SDS（Self-Rating Depression Scale）. Conclusion Extended care was effective in improving self-efficacy and reducing anxiety and depression of COPD patients. However, more quality studies are still in needs to interpret the results.