心理护理对缓解白血病患者心理压力的系统评价

Clinical efficacy of psychological intervention on leukemia patients: Meta-analysis

目的系统评价心理护理对缓解白血病患者心理压力的作用。方法计算机检索中国学术期刊全文数据库(CNKI)、维普、Pubmed和万方数据库,全面检索2003年5月～2016年5月发表的关于心理护理干预对白血病的相关临床研究。检索关键词设置为"白血病"、"心理护理"、"心理干预"、"临床研究"。Review Manager 5.3软件进行异质性检验,并根据异质性检验结果采用固定或随机效应模型合并OR值,P值及95%CI。结果最终对纳入的28篇文献进行Meta分析,共计病例2081例。在患者焦虑、抑郁方面,护理干预前后比较合并后效应量分别为OR=-13.05,95%CI=(-13.76,-12.34),P<0.00001以及OR=-12.7,95%CI=(-13.44,-11.95),P<0.00001。心理护理组与常规护理组相比,合并效应量OR=-7.46,95%CI=(-8.12,-6.80),P<0.00001以及OR=-7.72,95%CI=(-8.42,-7.02),P<0.00001。在患者依从性方面,分组比较合并后效应量OR=3.73,95%CI=(2.64,5.27),P<0.00001。另外,心理护理对患者家属焦虑、抑郁作用效果分析后获得一致效果。结论心理护理是缓解白血病患者心理压力、提高治疗依从性的有效方法。

Objective To investigate the clinical efficacy of psychological intervention on the stress burden of leukemia patients.Methods Studies related to psychological intervention to leukemia patients,from May 2005 to May 2016,were collected for meta-analysis by recalling databank based on the key words of leukemia,psychological nursing,psychological nursing and clinical research.Stata 12.0 was used for heterogeneity test and according to the results we determine if a fixed or a random effect model was used for getting the pooled RR,P value and the 95% confidence interval of RR.Results 28 references were enrolled for meta-analysis according to the inclusive and exclusive criteria,including 2081 cases.In aspect of anxiety and depression,before and after psychological intervention,the mixed results were OR=-13.05,95%CI=(-13.76,-12.34),P<0.00001 and OR=-12.7,95%CI=(-13.44,-11.95),P<0.00001.Compared psychological intervention group with conventional group,the mixed outcome were OR=-7.46,95%CI=(-8.12,-6.80),P<0.00001and OR=-7.72,95%CI=(-8.42,-7.02),P<0.00001.For patient’s compliance,the mixed result was OR=3.73,95%CI=(2.64,5.27),P<0.00001.Besides,we got the identical effects of psychological intervention on family’s stress.Conclusion Psychological intervention is effective for leukemia patients to relieve the psychological stress and improve the compliance.