精神分裂症社会心理干预临床实践指南的系统评价

Systematic review of clinical practice guidelines for psychosocial interventions in schizophrenia

目的 对精神分裂症社会心理干预相关指南进行系统评价,比较社会心理干预推荐意见的差异。方法 计算机检索国内外指南网、相关学会网站及数据库中关于精神分裂症社会心理干预的相关指南,检索时限为建库至2022年6月30日。采用指南方法学质量评价工具AGREEⅡ对指南进行质量评价,比较精神分裂症社会心理干预推荐意见的证据质量和推荐强度,分析推荐意见间的差异。结果 共纳入指南7篇,3篇为A级推荐,4篇为B级推荐。共提取12项社会心理干预措施,7篇指南中均建议精神分裂症患者应接受认知行为治疗和家庭治疗,其他社会心理干预措施推荐意见间存在明显差异。结论 指南的总体质量尚可,需详细阐述各推荐意见的实施策略,提供资源,探索长期应用效果,促进精神分裂症患者全面康复,为临床护理实践提供证据支持。

Objective To systematically review the related guidelines of psychosocial interventions in schizophrenia and compare the difference between the social psychological intervention recommendations,so as to provide a reference for psychiatric staff to carry out clinical practice.Methods The relevant guidelines on psychosocial intervention for schizophrenia in guideline networks,websites of relevant societies and databases at home and abroad were searched by computer,and the search time limit was from the establishment of the database to June 30,2022.AGREEⅡ,which was the methodological quality assessment tool for guidelines,was used to evaluate the quality of guidelines,,compare the evidence quality and recommendation strength of psychosocial intervention recommendations for schizophrenia,and analyze the heterogeneity of recommendations.Results A total of 7 guidelines were included,3 of which were rated as grade A recommendation,and 4 were rated as grade B recommendation.A total of 12 items of psychosocial intervention measures were extracted,and 7 guidelines of them were suggested that schizophrenia patients should receive cognitive behavioral therapy and family interventions,and there were significant differences in the recommendations of other psychosocial interventions.Conclusion The overall quality of the guidelines is acceptable.The guidelines need to specify the implementation strategies of each psychosocial intervention recommendations,provide resources,explore long-term application effects,promote long-term rehabilitation of schizophrenia patients,and provide evidence support for clinical nursing practice.