不同护理干预对糖尿病视网膜病变患者抑郁效果的系统评价
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摘要
目的系统评价不同护理干预对糖尿病视网膜病变(DR)患者抑郁的疗效。方法检索Cochrane图书馆(1980—2018)、PubMed(1966—2018)、CINAHL(1982—2018)、Web of science(1985—2018)、CNKI(1987—2018)、万方(不限—2018)和维普(不限—2018)中所有关于不同护理干预治疗DR患者抑郁的随机对照试验(randomized controlled trial,RCT),根据纳入和排除标准筛选文献、提取资料和进行质量评价后,采用RevMan5.3软件进行Meta分析。结果共纳入21篇RCT,Meta分析结果显示:不同护理干预较常规干预降低了DR患者的抑郁水平,合并效应有统计学意义[WMD=-6.47,95%CI(-8.25～-4.69),P<0.05];短期的护理干预能够显著降低DR患者抑郁水平;音乐放松疗法、家庭干预、药物治疗及心理护理干预方式对DR患者抑郁有显著效果,改善了患者的心理健康状态。结论对DR抑郁患者开展护理干预,尤其开展短期的音乐放松疗法能明显改善患者抑郁状态,促进患者康复,可对音乐放松疗法结合健康教育做进一步研究。
[Objective]To systematically evaluate the effect of different nursing interventions on depression of diabetic retinopathy(DR) patients.[Methods]The randomized controlled trials(RCT) about different nursing interventions on depression of DR patients were searched from the Cochrane library(1980-2018),PubMed(1966-2018),CINAHL(1982-2018),Web of science(1985-2018),CNKI(1987-2018),Wanfang(unlimited-2018),and Vip(unlimited-2018). Meta-analysis was conducted using RevMan5.3 software after literature screening,data extraction and quality evaluation according to inclusion and exclusion criteria.[Results]A total of 21 RCTs were included. The results of meta-analysis showed that different nursing interventions reduced the depression level of DR patients compared with conventional intervention,and the combined effect was statistically significant [WMD=-6.47,95%CI(-8.25--4.69),P<0.05]. Short-term nursing intervention can significantly reduce the depression level of DR patients. Music relaxation therapy,family intervention,drug treatment and psychological nursing intervention had sig nificant effects on the depression of DR patients and improved their mental health. [Conclusion]To carry out nursing intervention for DR patients with depression,especially short-term music relaxation therapy,can significantly improve the depression state of patients and promote their rehabilitation. Music relaxation therapy combined with healthy education should be further studied.
[Objective]To systematically evaluate the effect of different nursing interventions on depression of diabetic retinopathy(DR) patients.[Methods]The randomized controlled trials(RCT) about different nursing interventions on depression of DR patients were searched from the Cochrane library(1980-2018),PubMed(1966-2018),CINAHL(1982-2018),Web of science(1985-2018),CNKI(1987-2018),Wanfang(unlimited-2018),and Vip(unlimited-2018). Meta-analysis was conducted using RevMan5.3 software after literature screening,data extraction and quality evaluation according to inclusion and exclusion criteria.[Results]A total of 21 RCTs were included. The results of meta-analysis showed that different nursing interventions reduced the depression level of DR patients compared with conventional intervention,and the combined effect was statistically significant [WMD=-6.47,95%CI(-8.25--4.69),P<0.05]. Short-term nursing intervention can significantly reduce the depression level of DR patients. Music relaxation therapy,family intervention,drug treatment and psychological nursing intervention had sig nificant effects on the depression of DR patients and improved their mental health. [Conclusion]To carry out nursing intervention for DR patients with depression,especially short-term music relaxation therapy,can significantly improve the depression state of patients and promote their rehabilitation. Music relaxation therapy combined with healthy education should be further studied.
引文
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[3]张通.脑卒中的功能障碍与康复[M].北京:科学技术文献出版社,2006.22-26.
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[7]薛丽萍,罗鸿,谭朵,等.积极关注对于糖尿病视网膜病变Ⅱ期患者心理状态及生活质量的影响[J].海军医学杂志,2015(3):248-250.
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[10]区美仪,谭结梅,林秀琴,等.全程护理干预在糖尿病视网膜病变患者中的应用价值[J].中国当代医药,2018,25(12):183-185.
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[13]孙佳丽,杨滢瑞,成巧梅,等.叙事护理对围术期增生性糖尿病视网膜病变患者焦虑和抑郁的干预作用[J].临床医学,2018(5):123-125.
[14]REES G,O"HARE F,SAEED M,et al.Problem-solving therapy for adults with diabetic retinopathy and diabetes-specific distress:a pilot randomized controlled trial[J].BMJ Open Diab Res Care,2017,5(1):e000307.
[15]YU Y,FENG L,SHAO Y,et al.Quality of life and emotionalchange for middle-aged and elderly patients with diabetic retinopathy[J].Int J Ophthalmol,2013,6(1):71-74.
[16]丁莉莉.专项护理干预在糖尿病视网膜病变患者中的应用效果[J].护理实践与研究,2018,15(9):73-74.
[17]吴晓静.系统护理干预对糖尿病视网膜病变病人的影响[J].全科护理,2017,15(17):2105-2107.
[18]姚春红,杨杨.黛力新对糖尿病视网膜病变伴抑郁患者的疗效观察[J].微循环学杂志,2012,23(4):13-14.
[19]薛沛宏.家庭随访干预在早期糖尿病视网膜病变患者中的应用及效果[J].河北医药,2014,36(12):1896-1899.
[20]张晓芳.糖尿病视网膜病变玻璃体切割病人的健康教育[J].成都医学院学报,2012(b9):200-200.
[21]郭玉清.心理护理干预对糖尿病视网膜病变患者生活质量的影响[J].现代中西医结合杂志,2013,22(5):547-548.
[22]赵莉,孙月吉,刘启贵,等.音乐放松疗法对糖尿病视网膜病变患者生活质量的干预效应[J].中国组织工程研究,2005,9(28):50-53.
[23]魏霞,叶思勇,张晓越.预见性护理在糖尿病视网膜病变中的应用效果[J].国际护理学杂志,2018,37(1):68-70.
[24]牛淑玲,周志云.运动疗法治疗糖尿病视网膜病变临床疗效观察[J].国际眼科杂志,2011,11(10):1825-1826.
[25]蔺媛媛,高华,张晓宇,等.网络宣教改善非增殖型糖尿病视网膜病变患者自我管理能力和心理状态的研究[J].国际精神病学杂志,2018,45(3):573-576.
[26]任红英.个案管理在老年糖尿病患者护理中的应用分析[J].糖尿病新世界,2018(7):122-123.
[27]PIBERNIK-OKANOVIC M,PRASEK M,POlJICANIN-FIlIPOVIC T,et al.Effects of an empowerment-based psychosocial intervention on quality of life and metabolic control in type 2 diabetic patients[J].Patient Educ Couns,2004,52(2):193-199.
[28]林小红,林卓艳,陈琳.系统护理干预对DR患者不良心理、治疗依从性及生活质量的影响[J].齐鲁护理杂志,2016,22(5):17-18.
[29]黄瑞枝,张瑞娟.家属参与性延续护理对糖尿病视网膜病变患者健康行为习惯、服药准时率和生活质量的影响[J].护理实践与研究,2017,14(14):54-55.
[30]刘韶珠,顾烨,周红玉,等.早期糖尿病视网膜病变治疗与延伸护理进展[J].护理与康复,2015,14(6):528-530.
[31]王琴.糖尿病视网膜病变患者焦虑、抑郁水平及其影响因素[J].当代护士旬刊,2016(11):24-27.
[32]尹妮,赵帅,朱红娜.康柏西普预处理联合玻璃体切割术治疗增生型糖尿病视网膜病变[J].眼科新进展,2017,37(8):770-772.
[2]YANG W,LU J,WENG J,et al.Prevalence of Diabetes among Men and Women in China[J].N Engl J Med,2010,362(12):1090-1101.
[3]张通.脑卒中的功能障碍与康复[M].北京:科学技术文献出版社,2006.22-26.
[4]贾建平.神经病学[M].6版.北京:人民卫生出版社,2008.14-17.
[5]HIGGINS JPT,GREEN S.Cochrane Handbook for Systematic Reviews of Interventions 5.1.0[S/OL].(2011-12-06)[ttps://onlinelibrory.wiley.com/doi/abs/10.1002/jesm.38.
[6]吴建平,朱树贞.护理干预在糖尿病视网膜病变病人中的应用效果观察[J].护理研究,2015(12):1503-1505.
[7]薛丽萍,罗鸿,谭朵,等.积极关注对于糖尿病视网膜病变Ⅱ期患者心理状态及生活质量的影响[J].海军医学杂志,2015(3):248-250.
[8]TROZZOLINO L,THOMPSON P,TRANSMAN M,et al.Effects of a psychoeducational group on mood and glycemic control in adults with diabetes and visual impairments[J].J Visual Impair Blin,2003,97(4):230-239.
[9]迟静,万梅,陈晨,等.音乐放松疗法对糖尿病视网膜病变焦虑抑郁情绪、应对方式及生活质量的干预效果[J].国际精神病学杂志,2017,44(2):332-336.
[10]区美仪,谭结梅,林秀琴,等.全程护理干预在糖尿病视网膜病变患者中的应用价值[J].中国当代医药,2018,25(12):183-185.
[11]赵敏,徐凌忠.音乐放松疗法结合健康教育对糖尿病视网膜病变患者焦虑抑郁的影响[J].泰山医学院学报,2017,38(12):1405-1407.
[12]王彩霞,卢爱工,王雅静.心理干预对增殖型糖尿病性视网膜病变患者生存质量影响的研究[J].中华现代护理杂志,2007,13(31):2978-2980.
[13]孙佳丽,杨滢瑞,成巧梅,等.叙事护理对围术期增生性糖尿病视网膜病变患者焦虑和抑郁的干预作用[J].临床医学,2018(5):123-125.
[14]REES G,O"HARE F,SAEED M,et al.Problem-solving therapy for adults with diabetic retinopathy and diabetes-specific distress:a pilot randomized controlled trial[J].BMJ Open Diab Res Care,2017,5(1):e000307.
[15]YU Y,FENG L,SHAO Y,et al.Quality of life and emotionalchange for middle-aged and elderly patients with diabetic retinopathy[J].Int J Ophthalmol,2013,6(1):71-74.
[16]丁莉莉.专项护理干预在糖尿病视网膜病变患者中的应用效果[J].护理实践与研究,2018,15(9):73-74.
[17]吴晓静.系统护理干预对糖尿病视网膜病变病人的影响[J].全科护理,2017,15(17):2105-2107.
[18]姚春红,杨杨.黛力新对糖尿病视网膜病变伴抑郁患者的疗效观察[J].微循环学杂志,2012,23(4):13-14.
[19]薛沛宏.家庭随访干预在早期糖尿病视网膜病变患者中的应用及效果[J].河北医药,2014,36(12):1896-1899.
[20]张晓芳.糖尿病视网膜病变玻璃体切割病人的健康教育[J].成都医学院学报,2012(b9):200-200.
[21]郭玉清.心理护理干预对糖尿病视网膜病变患者生活质量的影响[J].现代中西医结合杂志,2013,22(5):547-548.
[22]赵莉,孙月吉,刘启贵,等.音乐放松疗法对糖尿病视网膜病变患者生活质量的干预效应[J].中国组织工程研究,2005,9(28):50-53.
[23]魏霞,叶思勇,张晓越.预见性护理在糖尿病视网膜病变中的应用效果[J].国际护理学杂志,2018,37(1):68-70.
[24]牛淑玲,周志云.运动疗法治疗糖尿病视网膜病变临床疗效观察[J].国际眼科杂志,2011,11(10):1825-1826.
[25]蔺媛媛,高华,张晓宇,等.网络宣教改善非增殖型糖尿病视网膜病变患者自我管理能力和心理状态的研究[J].国际精神病学杂志,2018,45(3):573-576.
[26]任红英.个案管理在老年糖尿病患者护理中的应用分析[J].糖尿病新世界,2018(7):122-123.
[27]PIBERNIK-OKANOVIC M,PRASEK M,POlJICANIN-FIlIPOVIC T,et al.Effects of an empowerment-based psychosocial intervention on quality of life and metabolic control in type 2 diabetic patients[J].Patient Educ Couns,2004,52(2):193-199.
[28]林小红,林卓艳,陈琳.系统护理干预对DR患者不良心理、治疗依从性及生活质量的影响[J].齐鲁护理杂志,2016,22(5):17-18.
[29]黄瑞枝,张瑞娟.家属参与性延续护理对糖尿病视网膜病变患者健康行为习惯、服药准时率和生活质量的影响[J].护理实践与研究,2017,14(14):54-55.
[30]刘韶珠,顾烨,周红玉,等.早期糖尿病视网膜病变治疗与延伸护理进展[J].护理与康复,2015,14(6):528-530.
[31]王琴.糖尿病视网膜病变患者焦虑、抑郁水平及其影响因素[J].当代护士旬刊,2016(11):24-27.
[32]尹妮,赵帅,朱红娜.康柏西普预处理联合玻璃体切割术治疗增生型糖尿病视网膜病变[J].眼科新进展,2017,37(8):770-772.