团体怀旧治疗对养老机构老年人抑郁症状干预效果的Meta分析

The effects of group reminiscence therapy on depressive symptoms in institutionalized elderly： a Meta-analysis

目的评价团体怀旧治疗对改善养老机构老年人抑郁症状的效果。方法计算机检索Cochrane图书馆、PubMed、CINAHL、PsycINFO、EMbase、中国生物医学文献数据库、中国期刊全文数据库、中国科技期刊数据库、万方数据库、台湾学术在线数据库、台湾华艺中文电子期刊等中、英文数据库。收集2000年至2016年11月团体怀旧治疗对改善养老机构老年人抑郁症状的临床随机对照试验、半随机对照试验或类试验，进行文献质量评价后，采用RevMan5．3软件进行数据分析。结果共纳入10项研究（2项随机对照试验，8项类试验），总样本量为511例。Meta分析结果显示，团体怀旧治疗在减轻抑郁程度、提高生活满意度和自尊水平上均有明显效果（95％可信区间-1．11— -0．56、0．41-2．05、1．99-3．82，均P〈0．01），在缓解孤独感方面，团体怀旧治疗和常规护理差异无统计学意义（P=0．21）。结论团体怀旧治疗能够改善养老机构老年人的抑郁症状，减轻抑郁程度，提高生活满意度和自尊水平，在缓解孤独感方面证据尚不足以证实疗效优于常规护理。本研究纳入的随机对照试验较少且文献质量一般，还有待更多高质量的研究予以证实。

Objective To evaluate the effect of group reminiscence therapy on improving the depressive symptoms of the institutionalized elderly. Methods Collecting clinical randomized controlled trials and quasi-randomized controlled trials of group reminiscence therapy for improving depressive symptoms in institutionalized elderly which published from 2000 to November 2016, by searching the Cochrane Library, PubMed, CINAHL, PsyclNFO, EMbase, China Biology Medicine, China National Knowledge Infrastructure, VIP, Wanfang Database, Taiwan Academic Online Database and Airiti Library. And reviewing the quality of the studies by using the tools for assessing risk of bias. RevMan 5.3 software was used for data analysis. Results Ten studies（2 randomized controlled trials and 8 quasi-experiments）, including a total of 511 cases, were included. The results showed that group reminiscence therapy significantly improved the depression, life satisfaction, and self-esteem of institutionalized elderly （95%CI- 1.11- -0.56, 0.41-2.05, 1.99-3.82, all P〈0.01）. There was no statistically significant difference between group reminiscence therapy and usual nursing in relieving loneliness （P = 0.21）. Conclusions Group reminiscence therapy can improve the depression in institutionalized elderly, decrease the degree of depression, improve the level of life satisfaction and self-esteem. But in the ease of loneliness has not been confirmed. The randomized controlled trials included in this study were rare and the quality of the literature was low, and large-scale randomized controlled trials of higher quality are needed to confirm this.