心理康复护理对脑卒中后吞咽障碍患者功能恢复影响的Meta分析

Meta-analysis of the effect of psychological nursing on the functional recovery of patients with dysphagia after stroke

目的采用Meta分析的方法评估心理康复护理对脑卒中后吞咽障碍患者功能恢复的影响。方法采用计算机检索PubMed、Cochrane Library、Web of Science、维普、万方数据网、中国知识基础设施工程和中国生物医学文献数据库,收集1956年6月至2020年8月发表的关于心理康复护理对于脑卒中后吞咽障碍患者功能的随机对照研究文献,采用Revman 5.3进行Meta分析。结果共纳入采用生命质量核心量表(QLQ-C30)和治疗疗效调查心理康复护理对脑卒中后吞咽障碍患者功能恢复影响及生命质量影响对照研究文献7篇,共660个样本。Meta分析结果显示:心理康复护理干预后心理功能均分差异有统计学意义[加权均数差(WMD)=-16.66,95%CI -18.09~-15.22,P<0.001];在躯体功能得分中,干预组表现相较于对照组差异有统计学意义(WMD=-14.10,95%CI -16.26~-11.95,P<0.001);心理康复护理干预后社会功能均分差异有统计学意义(WMD=-13.52,95%CI -15.64~-11.41,P<0.001);在生命质量评分中,对照组较干预组表现差(WMD=-14.58,95%CI -15.86~-13.31,P<0.001);干预组的治疗效果优于对照组的治疗效果,差异有统计学意义[比值比(OR)=0.16,95%CI 0.08~0.32,P<0.001]。结论通过心理康复护理的干预,脑卒中患者的吞咽障碍获得缓解同时,生命质量也会得到改善。

Objective To evaluate the influence of psychological nursing on the functional recovery of patients with dysphagia after stroke using the method of Meta analysis.Methods A computer search of PubMed,Cochrane Library,Web of Science,VIP,Wanfang Data,China Knowledge Infrastructure Engineering and China Biomedical Literature Database was used to collect the psychological nursing on the function of patients with dysphagia after stroke.The data were collected from June 1956 to August 2020.The literature of randomized controlled studies using Revman 5.3 for Meta analysis.Results A total of 7 controlled studies on the impact of the use of the core quality of life scale(QLQ-C30)and the treatment efficacy survey on the functional recovery of patients with dysphagia after stroke and the impact of quality of life were included,with a total of 660 samples.The results of Meta analysis showed that the average difference of mental function after psychological nursing intervention was statistically significant[weight mean difference(WMD)=-16.66,95%CI-18.09--15.22,P<0.001];in the physical function score,the intervention group performed relatively significant difference compared with the control group(WMD=-14.10,95%CI-16.26--11.95,P<0.001);the average difference in social function after psychological nursing intervention was statistically significant(WMD=-13.52,95%CI-15.64--11.41,P<0.001);in the quality of life score,the control group performed worse than the intervention group(WMD=-14.58,95%CI-15.86--13.31,P<0.001);the treatment effect of the intervention group was better than that of the control group,and the difference was statistically significant[odds ratio(OR)=0.16,95%CI 0.08-0.32,P<0.001].Conclusions Through the intervention of psychological care,the swallowing disorder of stroke patients is relieved and the quality of life is improved.