HIV/AIDS患者心理弹性干预研究的系统评价

A systematic review of the intervention research on resilience of HIV/AIDS patients

目的对国内外HIV/AIDS患者心理弹性干预研究进行系统评价,为提高我国HIV/AIDS患者心理弹性水平提供参考依据。方法检索中国知网、万方、维普、PubMed、Web of Science、The Cochrane Library等数据库,搜集针对HIV/AIDS患者心理弹性的干预研究,检索时限为1981年至2021年2月,根据PRISMA2009指南对文献进行筛选。采用RevMan 5.3软件对个案管理模式进行Meta分析,其他干预方法采用定性分析。结果最终共纳入10篇文献,描述了6种心理弹性干预方法,分别为认知行为疗法、基于多学科理论干预、记忆工作疗法、以病人为中心、聚焦解决模式及个案管理。Meta分析显示个案管理模式和常规管理模式的心理弹性差异有统计学意义(WMD=2.67,95%CI:1.12~4.23,P=0.0007)。其他干预方法中反映HIV/AIDS患者心理弹性的直接指标(CD-RISC)与间接指标(应对、适应、抑郁、焦虑、压力、披露、力量、优势、积极情绪)在干预前后有显著变化。结论6种针对HIV/AIDS患者心理弹性的干预方法对提升HIV/AIDS患者心理弹性具有良好效果,其中个案管理效果显著,其他方法由于研究数量有限,还需进一步研究予以评价。

Objective To evaluate the different intervention methods of the resilience of HIV/AIDS patients at home and abroad to provide a reference for improving the resilience level of HIV/AIDS patients in China.Methods We searched CNKI,Wanfang,VIP,PubMed,Web of Science,the Cochrane Library to collect intervention research on the resilience of HIV/AIDS patients.The retrieval period was from 1981 to February 2021,and the literature was screened according to PRISMA 2009 guidelines.RevMan 5.3 software was used to conduct a meta-analysis on the case management model,and qualitative analysis was used for other intervention methods.Results Finally,a total of 10 articles were included,and six kinds of resilience intervention methods were described,including cognitive behavior therapy,intervention based on multidisciplinary theory,memory work therapy,patient-centered and solution-focused models,and case management.Meta-analysis showed a significant difference in resilience between the case management and routine management models(WMD=2.67,95%CI:1.12-4.23,P=0.0007).The direct indicators(CD-RISC)and indirect indicators(copying,adaptation,depression,anxiety,stress,disclosure,strength,superiority,positive emotion)of HIV/AIDS patients showed significant changes before and after the intervention.Conclusion Six kinds of intervention methods for the resilience of HIV/AIDS patients have good effect on improving the resilience of HIV/AIDS patients,among which case management has a significant effect.However,due to the limited number of studies,other methods need to be further studied and evaluated.