心理干预对护理人员共情疲劳影响效果的Meta分析

The effectiveness of psychological intervention on nursing staff'compassion fatigue:a meta-analysis

目的系统评价心理干预对护理人员共情疲劳的影响。方法于2020年3至5月,检索PubMed、Cochrane Library、EMbase、Web of Science、中国知网、维普数据库、万方数据库等数据库,检索词主要包括compassion fatigue、nurs*、psychological intervention、mental intervention、RCT、共情疲劳、护理人员、心理干预、随机对照试验等,搜集心理干预对护理人员共情疲劳影响的随机对照试验(RCT),检索时间段为建库以来至2020年3月31日。筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 16.0软件计算合并心理干预对护理人员共情疲劳影响效果。结果共纳入13个RCT,包括940例护理人员。Meta分析结果显示,心理干预组共情疲劳总评分低于对照组(SMD=-0.96,95%CI:-1.17~-0.74,P=0.001),且共情满意评分(SMD=0.61,95%CI:0.45~0.77,P=0.002)、倦怠评分(SMD=-0.46,95%CI:-0.62~-0.29,P=0.006)、二次创伤评分(SMD=-0.40,95%CI:-0.68~-0.12,P=0.020)指标的改善均优于对照组。亚组分析显示,在不同干预时间(<8周和≥8周)和干预方式中,心理干预组比对照组更能有效提高共情满意评分,降低倦怠评分和二次创伤评分,差异均有统计学意义(P<0.05)。结论心理干预可提高护理人员共情满意水平,改善共情疲劳的症状,且对共情疲劳的发生发展有一定的预防作用。

Objective To systematically evaluate the impact of psychological intervention on nursing staff'compassion fatigue.Methods From March to May 2020,PubMed,Cochrane Library,EMbase,Web of Science,CNKI,VIP,Wanfang and other databases were electronically searched to collect randomized controlled trials(RCTs)on the influence of psychological intervention on nursing staff'compassion fatigue with the main search terms including compassion fatigue,nurs*,psychological intervention,mental intervention,RCT and so on from inception to March 31,2020.Screened literature,extracted data and assessed the risk of bias of included studies.The Stata 16.0 software was used to calculate the pooled effectiveness of psychological intervention on nursing staff'compassion fatigue.Results All 13 RCTs were enrolled,including 940 nursing staff.Meta-analysis results demonstrated that the psychological intervention group was superior to the control group in the improvement of the compassion fatigue score(SMD=-0.96,95%CI:-1.17-0.74,P=0.001),compassion satisfaction score(SMD=0.61,95%CI:0.45-0.77,P=0.002),burnout score(SMD=-0.46,95%CI:-0.62-0.29,P=0.006),secondary trauma score(SMD=-0.40,95%CI:-0.68-0.12,P=0.020),and the difference was statistically significant.Subgroup analysis found that the psychological intervention group was more effective than the control group in improving compassion satisfaction score,reducing burnout score and secondary trauma score,and the differences were statistically significant(P<0.05)in different intervention time(<8 weeks and≥8 weeks)and intervention methods.Conclusion The psychological intervention can improve the level of compassion satisfaction,and reduce the compassion fatigue among nursing staff,and have a certain preventive effect on compassion fatigue.