延续性护理对血液透析患者焦虑抑郁情绪影响的meta分析

Meta-analysis of influence of continuous nursing on anxiety and depression in hemodialysis patients

目的 采用meta分析评价延续性护理对改善血液透析(HD)患者焦虑、抑郁情绪的效果。方法 系统检索CNKI、VIP、万方、CMB、The Cochrane Library、Web of science、PubMed、Embase中关于延续性护理对改善HD患者焦虑、抑郁情绪、生活质量以及并发症发生率效果的RCT,检索时间均为建库至2021年10月,应用RevMan 5.4软件对纳入的文献进行meta分析。结果 共纳入19项RCT,1711例患者,结果显示,常规护理联合延续性护理干预后,患者的焦虑状态[MD=-9.55,95%CI(-11.37,-7.73),P <0.000 01]、抑郁状态[MD=-8.83,95%CI(-10.87,-6.79),P <0.000 01]均有改善,干预后能显著提高患者生活质量[MD=11.74,95%CI(10.63,12.85),P <0.000 01],减少并发症[RR=0.45,95%CI(0.31,0.65),P <0.0001]。结论 结果表明,常规护理联合延续性护理能改善HD患者焦虑、抑郁不良情绪,降低并发症发生率,提高患者生活质量,其中焦虑、抑郁情绪的改善效果与干预时间、患者年龄相关。

Objective To evaluate the effect of continuous nursing on anxiety and depression in hemodialysis(HD) patients by meta-analysis. Methods The RCTs of CNKI, VIP, Wanfang, CMB, The Cochrane Library,Web of science, PubMed, and Embase on the effects of continuous nursing on the improvement of anxiety,depression, quality of life, and the incidence of complications in HD patients that were input from the database establishment to October 2021 were systematically retrieved. The meta-analysis of the included articles was performed using RevMan 5.4 software. Results A total of 19 RCTs were included, and 1,711 patients were included. The results showed that after the combination of routine nursing and continuous nursing intervention,the anxiety state [MD=-9.55, 95% CI(-11.37,-7.73), P < 0.000 01] and depression state [MD=-8.83,95% CI(-10.87,-6.79), P < 0.000 01] of patients were all improved. Intervention also significantly improved the quality of life of patients [MD=11.74, 95% CI(10.63, 12.85), P < 0.000 01] and reduced complications [RR=0.45, 95% CI(0.31, 0.65), P < 0.0001]. Conclusion The existing results show that routine nursing combined with continuous nursing can improve anxiety and depression in HD patients, reduce the incidence of complications, and improve the quality of life of patients. The improvement of anxiety and depression is related to the intervention time and age of patients.