炎症性肠病患者焦虑和抑郁管理的证据总结

Summary of evidence for management of anxiety and depression in patients with inflammatory bowel disease

目的检索和分析炎症性肠病患者焦虑和抑郁管理的相关证据,并对最佳证据进行总结。方法计算机检索BMJ Best Practice、JBI循证卫生保健中心数据库、UptoDate、美国指南网、英国国家临床医学研究所指南库、苏格兰校际指南网、世界胃肠病组织网、PubMed、Cochrane Library、Embase、CINAHL、PsycInfo、中国生物医学文献数据库、CNKI和万方数据库中有关炎症性肠病患者焦虑和抑郁管理的指南、证据总结、专家共识、最佳信息实践册、推荐实践和系统评价。检索时限为建库至2020年4月20日。对纳入文献进行质量评价和证据汇总。结果共纳入12篇文献,其中指南3篇、专家共识3篇、系统评价6篇。最终提取并综合成筛查、评估和管理共3个层面、20条证据,其中管理维度又可以细化为信息支持、情感支持、心理干预、戒烟戒酒、运动锻炼5个方面。结论应用证据时需结合机构的环境、现有条件、决策者意愿、患者意愿及证据应用的促进、障碍因素,对证据进行个体化调整,以科学的方式管理炎症性肠病患者的心理问题,保证护理质量。

Objective To retrieve and analyze related evidence for management of anxiety and depression in patients with inflammatory bowel disease and summarize the best evidence.Methods BMJ Best Practice,Joanna Briggs Institute Evidence-based Healthcare Center Database,UptoDate,National Guideline Clearinghouse(NGC),National Institute for Health and Care Excellence(NICE),Scottish Intercollegiate Guidelines Network(SIGN),World Gastroenterology Organization,PubMed,Cochrane Library,Embase,CINAHL,PsycInfo,China Biology Medicine disc,CNKI and Wanfang Database were searched by computer for guidelines,evidence summaries,expert consensus,best information practice booklet,recommended practices and systematic reviews on management of anxiety and depression in patients with inflammatory bowel disease.The retrieval time was from establishment of the database to April 20,2020.Quality evaluation and evidence summary of the included literature were conducted.Results A total of 12 articles were included,including 3 guidelines,3 expert consensus and 6 systematic reviews.Finally,it was extracted and integrated into 3 levels of screening,evaluation and management,with 20 pieces of evidence.Among them,the management dimension could be refined into 5 aspects including information support,emotional support,psychological intervention,quitting smoking and drinking and exercise.Conclusions The application of evidence should be adjusted individually according to the institutional environment,existing conditions,wishes of decision makers,wishes of patients and impediments to the application of evidence,so as to manage psychological problems of patients with inflammatory bowel disease in a scientific way and ensure the quality of nursing.