自助干预模式在成年抑郁症患者中应用效果的范围综述

Scoping review of application effects of self-help intervention model in adult patients with depression

目的对自助干预模式在成年抑郁症患者中应用的相关研究进行范围综述,分析自助干预模式的主要特征及应用效果,以期为该领域相关研究提供参考。方法依据范围综述的方法学框架,检索建库至2021年4月20日中国知网、万方、PubMed、Web of Science等12个中英文数据库,对获得文献进行整理和分析。结果共纳入45篇文献,其中来自中国的文献仅5篇;纳入的研究主要基于互联网平台,采用认知行为疗法、阅读疗法、接受与承诺疗法和问题解决疗法等策略进行干预;干预时长3周至4个月,参与者平均每3~7 d完成1个干预模块或阅读指定数量的章节,每1~2周接受1次干预引导者的定期引导和监督,与引导者的总接触时间为80~160 min;基于互联网的各类自助干预模式可以有效地改善抑郁症患者的不良情绪。结论自助干预模式在抑郁症患者治疗中已呈现良好效果,但我国本土干预研究缺乏,干预引导者的引导次数、引导时长尚无明确标准。在"互联网+医疗健康"的大趋势下,应积极构建具有中国文化特色的抑郁症自助干预模式,形成系统、规范的干预策略,以解决抑郁症人群在时间、地域、资源和成本上存在的诸多障碍,最终达到改善患者抑郁症状,帮助其恢复社会功能的目的。

Objective To review relevant research on the application of self-help intervention model in adult depression patients,analyze the main characteristics and application effects of self-help intervention model,in order to provide reference for related research in this field.Methods According to the methodological framework of the scope review,searched 12 Chinese and English databases including CNKI,Wanfang,PubMed,Web of Science,etc.from the establishment of the database until April 20,2021,and sorted and analyzed the obtained documents according to the inclusion and exclusion standards.Results A total of 45 documents were included,of which only 5 were from China;the included studies were mainly based on the Internet platform,using cognitive behavioral therapy,reading therapy,acceptance and commitment therapy,and problem-solving therapy for intervention;the duration of the intervention was 3 weeks to 4 months,participants complete an intervention module or read a specified number of chapters every 3 to 7 days on average,and receive regular guidance and supervision from the intervention facilitator every 1-2 weeks.The total contact time with the facilitator was 80-160 minutes.Various modes of self-help intervention based on the Internet could effectively improve the negative emotions of patients with depression.Conclusions The self-help intervention model has shown good results in the treatment of patients with depression,but there is a lack of local intervention research in China,and there is no clear standard for the number of interventions and the length of the intervention guide.Under the general trend of"Internet+medical health",it is necessary to actively construct a self-help intervention model for depression with Chinese cultural characteristics,and form a systematic and standardized intervention strategy to address the many obstacles in time,location,resources and cost of people with depression,and finally achieve the purpose of improving the patients′depressive symptoms and helping them to restore their social functions.