心理护理对缓解白血病患者心理压力的系统评价
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摘要
目的系统评价心理护理对缓解白血病患者心理压力的作用。方法计算机检索中国学术期刊全文数据库(CNKI)、维普、Pubmed和万方数据库,全面检索2003年5月～2016年5月发表的关于心理护理干预对白血病的相关临床研究。检索关键词设置为"白血病"、"心理护理"、"心理干预"、"临床研究"。Review Manager 5.3软件进行异质性检验,并根据异质性检验结果采用固定或随机效应模型合并OR值,P值及95%CI。结果最终对纳入的28篇文献进行Meta分析,共计病例2081例。在患者焦虑、抑郁方面,护理干预前后比较合并后效应量分别为OR=-13.05,95%CI=(-13.76,-12.34),P<0.00001以及OR=-12.7,95%CI=(-13.44,-11.95),P<0.00001。心理护理组与常规护理组相比,合并效应量OR=-7.46,95%CI=(-8.12,-6.80),P<0.00001以及OR=-7.72,95%CI=(-8.42,-7.02),P<0.00001。在患者依从性方面,分组比较合并后效应量OR=3.73,95%CI=(2.64,5.27),P<0.00001。另外,心理护理对患者家属焦虑、抑郁作用效果分析后获得一致效果。结论心理护理是缓解白血病患者心理压力、提高治疗依从性的有效方法。
Objective To investigate the clinical efficacy of psychological intervention on the stress burden of leukemia patients.Methods Studies related to psychological intervention to leukemia patients, from May 2005 to May 2016, were collected for meta-analysis by recalling databank based on the key words of leukemia, psychological nursing, psychological nursing and clinical research. Stata 12.0 was used for heterogeneity test and according to the results we determine if a fixed or a random effect model was used for getting the pooled RR, P value and the 95% confidence interval of RR.Results 28 references were enrolled for meta-analysis according to the inclusive and exclusive criteria, including 2081 cases. In aspect of anxiety and depression, before and after psychological intervention, the mixed results were OR=-13.05, 95%CI=(-13.76,-12.34), P<0.00001 and OR=-12.7, 95%CI=(-13.44,-11.95), P<0.00001. Compared psychological intervention group with conventional group, the mixed outcome were OR=-7.46, 95%CI=(-8.12,-6.80), P<0.00001 and OR=-7.72, 95%CI=(-8.42,-7.02), P<0.00001. For patient's compliance, the mixed result was OR=3.73, 95%CI=(2.64, 5.27), P<0.00001. Besides, we got the identical effects of psychological intervention on family's stress. Conclusion Psychological intervention is effective for leukemia patients to relieve the psychological stress and improve the compliance.
Objective To investigate the clinical efficacy of psychological intervention on the stress burden of leukemia patients.Methods Studies related to psychological intervention to leukemia patients, from May 2005 to May 2016, were collected for meta-analysis by recalling databank based on the key words of leukemia, psychological nursing, psychological nursing and clinical research. Stata 12.0 was used for heterogeneity test and according to the results we determine if a fixed or a random effect model was used for getting the pooled RR, P value and the 95% confidence interval of RR.Results 28 references were enrolled for meta-analysis according to the inclusive and exclusive criteria, including 2081 cases. In aspect of anxiety and depression, before and after psychological intervention, the mixed results were OR=-13.05, 95%CI=(-13.76,-12.34), P<0.00001 and OR=-12.7, 95%CI=(-13.44,-11.95), P<0.00001. Compared psychological intervention group with conventional group, the mixed outcome were OR=-7.46, 95%CI=(-8.12,-6.80), P<0.00001 and OR=-7.72, 95%CI=(-8.42,-7.02), P<0.00001. For patient's compliance, the mixed result was OR=3.73, 95%CI=(2.64, 5.27), P<0.00001. Besides, we got the identical effects of psychological intervention on family's stress. Conclusion Psychological intervention is effective for leukemia patients to relieve the psychological stress and improve the compliance.
引文
[1] Manitta V, Zordan R, Cole-Sinclair M, et al. The symptom burden of patients with hematological malignancy: a cross-sectional observational study[J]. Journal of pain and symptom management, 2011, 42(3):432-442.
[2] Gupta V, Singh A, Singh TB, et al. Psychological morbidity in children undergoing chemotherapy for acute lymphoblastic leukemia[J]. Indian journal of pediatrics, 2014, 81(7):699-701.
[3] 张晋碚, 周英, 关念红, 等. 急性白血病病人心理状态调查[J]. 中国行为医学科学, 2001,10(4):26-27.
[4] 葛啸天, 黄洁敏, 顾妙娟. 白血病患者心理历程的质性研究[J]. 护理学杂志, 2009,34(17):69-72.
[5] Digilio G, Digilio M. Medical progress, psychological factors and global care of the patient: lessons from the treatment of childhood leukemia[J]. Annali dell'Istituto superiore di sanita, 2013, 49(1):92-96.
[6] 张彩霞, 张彩萍. 心理干预对白血病患者的影响[J]. 中国民族民间医药, 2011,20(22):67.
[7] 杨慧华. 心理护理干预对白血病抑郁障碍的影响[J]. 中国医药指南, 2016,14(14):238.
[8] 纪娜. 护理干预对进行化疗的急性白血病患者焦虑和抑郁情绪及生活质量的影响[J]. 现代中西医结合杂志, 2016,25(18):2044-2046.
[9] 郑琼珍. 白血病患者心理状况调查及护理干预[J]. 中国医学创新, 2012,9(2):127-128.
[10] 王慧. 白血病30例心理护理[J]. 齐鲁护理杂志, 2012,18(13):110-111.
[11] 贾宜, 李红. 白血病化疗后心理干预的重要性研究[J]. 当代医学, 2013,19(22):29-30.
[12] 陈玉红, 李海容. 白血病患者的心理护理[J]. 医学信息, 2008,21(1):130-131.
[13] 罗百花, 简静, 谭禾英, 等. 白血病患者焦虑和抑郁状况调查及心理干预[J].中国医学工程, 2011,19(3):42-43.
[14] 肖文琼.白血病患者心理护理中护理程序的应用效果分析[J]. 当代医学, 2015,21(34):116-117.
[15] 陈淑珍.对进行化疗的急性髓系白血病患者实施心理护理的效果分析[J]. 当代医药论丛, 2016,14(19):153-155.
[16] 符忠佩, 张建江.急性淋巴细胞白血病患儿心理干预研究[J]. 临床心身疾病杂志, 2004,10(4):264-265.
[17] 朱登萍, 隋艳, 顾靖, 等.结构性心理干预对白血病患者首次化疗心理状态的影响调查[J]. 慢性病学杂志, 2010,12(3):287-288.
[18] 陈美佳, 李玲琍.强化心理护理干预对急性髓系白血病化疗患者的影响[J]. 华南国防医学杂志, 2015,29(6):473-475.
[19] 李小云, 张静平, 彭芳, 等.认知心理干预提高急性白血病化疗患者的生活质量[J]. 中国心理卫生杂志, 2011,14(5):332-333.
[20] 韦海肖. 心理干预对白血病患者化疗依从性的影响[J].临床心身疾病杂志, 2008,14(4):363.
[21] 韦婷. 心理干预对白血病患者化疗依从性的影响[J].护理实践与研究, 2008,5(4):83.
[22] 周丽, 韩传平, 张翠芹, 等.心理干预对白血病患者心理状态及化疗依从性的影响[J].中国行为医学科学, 2003,12(4):41-43.
[23] 于明峰, 阮海涛, 徐丽.心理干预对行造血干细胞移植的白血病患者抑郁、焦虑及生存质量的影响[J]. 中国康复, 2014,29(5):377-378.
[24] 刘树霞.心理干预对急性淋巴细胞白血病患儿父母焦虑的影响[J].内蒙古中医药, 2014,33(23):148-149.
[25] 胡莉萍, 桂慧华.心理干预对老年白血病患者负性心理的影响[J].临床血液学杂志(输血与检验版), 2007,4(5):222-224.
[26] 刘佳璋.心理干预在慢性白血病患者焦虑抑郁情绪干预的效果[J].哈尔滨医药, 2016,36(1):89-91.
[27] 王颖.心理护理对白血病患者心理状态及生活质量的影响[J].现代诊断与治疗, 2013,24(3):710-711.
[28] 王怀素.心理护理干预对小儿白血病病人心理状况影响的研究[J].临床医学工程, 2014,21(11):1489-1490.
[29] 叶串连.心理护理及健康教育对白血病化疗患者的影响[J].中国社区医师(医学专业), 2012,14(10):371-372.
[30] 梅俊辉.综合心理干预对白血病患者情绪状况及生活质量的影响[J].中国医药导报, 2011,8(33):130-131.
[31] 朱丽,冯蓉蓉,陶媛,等.急性白血病患者家属心理状况调查及心理护理效果[J].当代护士(下旬刊), 2015,(6):126-127.
[32] 程金敏,周娟,但德莉.家属心理护理干预对白血病病人心理状况的影响[J].全科护理, 2014,12(12):1089-1090.
[33] 孙淑华,秦殿菊,林占峰,等.综合心理干预对白血病患者家属焦虑抑郁的影响[J].承德医学院学报, 2010,27(2):165-166.
[34] 晋建芳.心理护理研究新进展[J].医学理论与实践, 2015,28(13):1724-1726.
[35] Albrecht TA,Rosenzweig M. Distress in patients with acute leukemia: A concept analysis[J]. Cancer nursing,2014,37(3):218-226.
[36] Myers RM,Balsamo L,Lu X, et al. A prospective study of anxiety,depression, and behavioral changes in the first year after a diagnosis of childhood acute lymphoblastic leukemia: a report from the Children's Oncology Group[J]. Cancer, 2014, 120(9):1417-1425.
[37] Baytan B, Asut C, Cirpan Kantarcioglu A, et al.Health-Related Quality of Life, Depression, Anxiety, and Self-Image in Acute Lymphocytic Leukemia Survivors[J]. Turkish journal of haematology: official journal of Turkish Society of Haematology, 2016,33(4):326-330.
[38] 吴心怡,张瑞东,刘华清,等.白血病患儿父母焦虑抑郁的调查和干预[J].中国心理卫生杂志, 2009,23(5):311-315.
[39] Neu M, Matthews E, King NA, et al.Anxiety, depression, stress, and cortisol levels in mothers of children undergoing maintenance therapy for childhood acute lymphoblastic leukemia[J].Journal of pediatric oncology nursing: official journal of the Association of Pediatric Oncology Nurses, 2014,31(2):104-113.
[2] Gupta V, Singh A, Singh TB, et al. Psychological morbidity in children undergoing chemotherapy for acute lymphoblastic leukemia[J]. Indian journal of pediatrics, 2014, 81(7):699-701.
[3] 张晋碚, 周英, 关念红, 等. 急性白血病病人心理状态调查[J]. 中国行为医学科学, 2001,10(4):26-27.
[4] 葛啸天, 黄洁敏, 顾妙娟. 白血病患者心理历程的质性研究[J]. 护理学杂志, 2009,34(17):69-72.
[5] Digilio G, Digilio M. Medical progress, psychological factors and global care of the patient: lessons from the treatment of childhood leukemia[J]. Annali dell'Istituto superiore di sanita, 2013, 49(1):92-96.
[6] 张彩霞, 张彩萍. 心理干预对白血病患者的影响[J]. 中国民族民间医药, 2011,20(22):67.
[7] 杨慧华. 心理护理干预对白血病抑郁障碍的影响[J]. 中国医药指南, 2016,14(14):238.
[8] 纪娜. 护理干预对进行化疗的急性白血病患者焦虑和抑郁情绪及生活质量的影响[J]. 现代中西医结合杂志, 2016,25(18):2044-2046.
[9] 郑琼珍. 白血病患者心理状况调查及护理干预[J]. 中国医学创新, 2012,9(2):127-128.
[10] 王慧. 白血病30例心理护理[J]. 齐鲁护理杂志, 2012,18(13):110-111.
[11] 贾宜, 李红. 白血病化疗后心理干预的重要性研究[J]. 当代医学, 2013,19(22):29-30.
[12] 陈玉红, 李海容. 白血病患者的心理护理[J]. 医学信息, 2008,21(1):130-131.
[13] 罗百花, 简静, 谭禾英, 等. 白血病患者焦虑和抑郁状况调查及心理干预[J].中国医学工程, 2011,19(3):42-43.
[14] 肖文琼.白血病患者心理护理中护理程序的应用效果分析[J]. 当代医学, 2015,21(34):116-117.
[15] 陈淑珍.对进行化疗的急性髓系白血病患者实施心理护理的效果分析[J]. 当代医药论丛, 2016,14(19):153-155.
[16] 符忠佩, 张建江.急性淋巴细胞白血病患儿心理干预研究[J]. 临床心身疾病杂志, 2004,10(4):264-265.
[17] 朱登萍, 隋艳, 顾靖, 等.结构性心理干预对白血病患者首次化疗心理状态的影响调查[J]. 慢性病学杂志, 2010,12(3):287-288.
[18] 陈美佳, 李玲琍.强化心理护理干预对急性髓系白血病化疗患者的影响[J]. 华南国防医学杂志, 2015,29(6):473-475.
[19] 李小云, 张静平, 彭芳, 等.认知心理干预提高急性白血病化疗患者的生活质量[J]. 中国心理卫生杂志, 2011,14(5):332-333.
[20] 韦海肖. 心理干预对白血病患者化疗依从性的影响[J].临床心身疾病杂志, 2008,14(4):363.
[21] 韦婷. 心理干预对白血病患者化疗依从性的影响[J].护理实践与研究, 2008,5(4):83.
[22] 周丽, 韩传平, 张翠芹, 等.心理干预对白血病患者心理状态及化疗依从性的影响[J].中国行为医学科学, 2003,12(4):41-43.
[23] 于明峰, 阮海涛, 徐丽.心理干预对行造血干细胞移植的白血病患者抑郁、焦虑及生存质量的影响[J]. 中国康复, 2014,29(5):377-378.
[24] 刘树霞.心理干预对急性淋巴细胞白血病患儿父母焦虑的影响[J].内蒙古中医药, 2014,33(23):148-149.
[25] 胡莉萍, 桂慧华.心理干预对老年白血病患者负性心理的影响[J].临床血液学杂志(输血与检验版), 2007,4(5):222-224.
[26] 刘佳璋.心理干预在慢性白血病患者焦虑抑郁情绪干预的效果[J].哈尔滨医药, 2016,36(1):89-91.
[27] 王颖.心理护理对白血病患者心理状态及生活质量的影响[J].现代诊断与治疗, 2013,24(3):710-711.
[28] 王怀素.心理护理干预对小儿白血病病人心理状况影响的研究[J].临床医学工程, 2014,21(11):1489-1490.
[29] 叶串连.心理护理及健康教育对白血病化疗患者的影响[J].中国社区医师(医学专业), 2012,14(10):371-372.
[30] 梅俊辉.综合心理干预对白血病患者情绪状况及生活质量的影响[J].中国医药导报, 2011,8(33):130-131.
[31] 朱丽,冯蓉蓉,陶媛,等.急性白血病患者家属心理状况调查及心理护理效果[J].当代护士(下旬刊), 2015,(6):126-127.
[32] 程金敏,周娟,但德莉.家属心理护理干预对白血病病人心理状况的影响[J].全科护理, 2014,12(12):1089-1090.
[33] 孙淑华,秦殿菊,林占峰,等.综合心理干预对白血病患者家属焦虑抑郁的影响[J].承德医学院学报, 2010,27(2):165-166.
[34] 晋建芳.心理护理研究新进展[J].医学理论与实践, 2015,28(13):1724-1726.
[35] Albrecht TA,Rosenzweig M. Distress in patients with acute leukemia: A concept analysis[J]. Cancer nursing,2014,37(3):218-226.
[36] Myers RM,Balsamo L,Lu X, et al. A prospective study of anxiety,depression, and behavioral changes in the first year after a diagnosis of childhood acute lymphoblastic leukemia: a report from the Children's Oncology Group[J]. Cancer, 2014, 120(9):1417-1425.
[37] Baytan B, Asut C, Cirpan Kantarcioglu A, et al.Health-Related Quality of Life, Depression, Anxiety, and Self-Image in Acute Lymphocytic Leukemia Survivors[J]. Turkish journal of haematology: official journal of Turkish Society of Haematology, 2016,33(4):326-330.
[38] 吴心怡,张瑞东,刘华清,等.白血病患儿父母焦虑抑郁的调查和干预[J].中国心理卫生杂志, 2009,23(5):311-315.
[39] Neu M, Matthews E, King NA, et al.Anxiety, depression, stress, and cortisol levels in mothers of children undergoing maintenance therapy for childhood acute lymphoblastic leukemia[J].Journal of pediatric oncology nursing: official journal of the Association of Pediatric Oncology Nurses, 2014,31(2):104-113.