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目的 评价认知行为疗法对重症患儿家属心理健康状况的干预效果。方法 通过计算机检索从建库至2020年12月PubMed、PsychINFO、Embase、Web of Science、the Cochrane Library、CINAHL Complete、中国生物医学文献数据库、中国知网、万方数据库和维普中文期刊数据库中有关认知行为疗法对重症患儿家属应用效果评价的临床对照研究，使用RevMan 5.3统计软件进行meta分析。结果 共纳入9项研究进行meta分析，结果显示，认知行为疗法可缓解重症患儿家属创伤后应激状况[SMD=-0.34(95%CI:-0.59～-0.08),Z=2.59,P=0.01]和焦虑状况[SMD=-0.36(95%CI:-0.55～-0.18),Z=3.89,P <0.001]，但对缓解抑郁状况差异无统计学意义[SMD=-0.33(95%CI:-0.89～0.24),Z=1.12,P=0.26]。结论 认知行为疗法可以缓解重症患儿家属创伤后应激和焦虑状况，但对改善其抑郁状况效果不明显。受限于目前纳入研究的方法、研究数量和研究质量的影响，尚需开展更多高质量、大样本和多中心的临床随机对照试验，以进一步探索和评价其应用成效，增加证据强度。
Abstract：Objective To evaluate the effect of cognitive-behavioral therapy on caregivers' mental health of critically ill children.Methods A systematic search for literature of clinical controlled trials of the effect of cognitive-behavioral therapy on caregivers' mental health of critically ill children was conducted through PubMed, PsychINFO, Embase, Web of Science, the Cochrane Library, CINAHL Complete, Chinese Biomedical Literature Database, CNKI, Wanfang Database, and Weipu Chinese Journal Database from the establishment of these databases to December 2020. RevMan 5. 3 statistical software was used for meta analysis.Results Data from 9 studies were included in the meta analysis. The results showed that cognitive behavioral therapy could alleviate post-traumatic stress [SMD =-0. 34(95% CI:-0. 59--0. 08), Z = 2. 59, P = 0. 01] and anxiety [SMD =-0. 36(95% CI:-0. 55--0. 18), Z = 3. 89, P < 0. 001] of critically ill children's caregivers, but it had no significant effect on their depression level [SMD =-0. 33(95% CI:-0. 89-0. 24), Z = 1. 12, P = 0. 26]. Conclusion Cognitive behavioral therapy can relieve post-traumatic stress and anxiety of critically ill children's caregivers, but it has no effect on alleviating their depression. Due to limitation of the methods, number and quality of the included studies, more high-quality, large-sample and multi-center clinical randomized controlled trials are needed to further explore and evaluate its effectiveness and strengthen the evidence.
[1] Smith HA, Gangopadhyay M, Goben CM, et al.Monitoring for critically ill infants and children[J]. Crit Care Med, 2016,44(3):592-600.
[2] Le Brocque RM, Dow BL, McMahon H, et al. The course of posttraumatic stress in children:examination of symptom trajectories and predictive factors following admission to pediatric intensive care[J]. Pediatr Crit Care Med, 2020,21(7):e399-e406.
[3] Rodriguez-Rubio M, Pinto NP, Manning JC, et al. Postintensive care syndrome in paediatrics:setting our sights on survivorship[J]. Lancet Child Adolesc Health, 2020,4(7):486-488.
[4] Nelson LP, Lachman SE, Li SW, et al. The Effects of family functioning on the development of posttraumatic stress in children and their parents following admission to the PICU[J]. Pediatr Crit Care Med, 2019,20(4):e208-e215.
[5] Rodríguez-Rey R, Alonso-Tapia J, Colville G. Prediction of parental posttraumatic stress, anxiety and depression after a child’s critical hospitalization[J]. J Crit Care, 2018,45:149-155.
[6] Nelson LP, Gold JI. Posttraumatic stress disorder in children and their parents following admission to the pediatric intensive care unit:a review[J]. Pediatr Crit Care Med, 2012,13(3):338-347.
[7] Yagiela LM, Carlton EF, Meert KL, et al. Parent medical traumatic stress and associated family outcomes after pediatric critical illness:a systematic review[J]. Pediatr Crit Care Med, 2019,20(8):759-768.
[8] Kudchadkar SR, Nelliot A, Awojoodu R, et al. Physical rehabilitation in critically ill children:a multicenter point prevalence study in the united states[J]. Crit Care Med, 2020,48(5):634-644.
[9] Merbitz NH, Westie K, Dammeyer JA, et al. After critical care:challenges in the transition to inpatient rehabilitation[J]. Rehabil Psychol, 2016,61(2):186-200.
[10] Wieczorek B, Ascenzi J, Kim Y, et al. PICU up!:impact of a quality improvement intervention to promote early mobilization in critically ill children[J]. Pediatr Crit Care Med, 2016, 17(12):e559-e566.
[11] Mikkelsen G. The meaning of personal diaries to children and families in the paediatric intensive care unit:a qualitative study[J]. Intensive Crit Care Nurs,2017,45(19):25-30.
[12] Ekim A. The post-intensive care syndrome in children[J]. Compr Child Adolesc Nurs, 2020,43(1):15-21.
[13] Mianaei SJ, Karahroudy FA, Rassouli M, et al. The effect of creating opportunities for parent empowerment program on maternal stress, anxiety, and participation in NICU wards in Iran[J]. Iran J Nurs Midwifery Res,2014,19(1):94-100.
[14] Aita M, Héon M, Savanh P, et al. Promoting family and siblings’ adaptation following a preterm birth:a quality improvement project of a family-centered care nursing educational intervention[J]. J Pediatr Nurs,2020,58:21-27.
[15] Shaw RJ, St John N, Lilo EA, et al. Prevention of traumatic stress in mothers with preterm infants:a randomized controlled trial[J]. Pediatrics, 2013,132(4):e886-e894.
[16] Wu Q, Li J, Parrott S, et al. Cost-effectiveness of different formats for delivery of cognitive behavioral therapy for depression:a systematic review based economic model[J]. Value Health, 2020,23(12):1662-1670.
[17] Zegarow P, Manczak M, Rysz J, et al. The influence of cognitive-behavioral therapy on depression in dialysis patients-meta-analysis[J]. Arch Med Sci, 2020,16(6):1271-1278.
[18] Bernard RS, Williams SE, Storfer-Isser A, et al. Brief cognitive-behavioral intervention for maternal depression and trauma in the neonatal intensive care unit:a pilot study[J]. J Traum Stress, 2011,24(2):230-234.
[19] Deeks JJ, Higgins JP, Altman DG, et al. Analysing data and undertaking meta-analyses[EB/OL].(2017-06-01)[2021-08-12]. www.training.cochrane.org/handbook.
[20] Hagan R, Evans SF, Pope S. Preventing postnatal depression in mothers of very preterm infants:a randomised controlled trial[J]. BJOG, 2004,111(7):641-647.
[21] Samani E, Ahmadib A, Sharif H. Effectiveness of cognitive-behavioral counseling on the mental health of premature infants’ mothers in neonatal intensive care unit[J]. J Neonat Nurs,2020,26(5):263-267.
[22] Shaw RJ, St John N, Lilo E, et al. Prevention of traumatic stress in mothers of preterms:6-month outcomes[J]. Pediatrics, 2014,134(2):e481-e488.
[23] Silverstein M, Feinberg E, Cabral H, et al. Problemsolving education to prevent depression among low income mothers of preterm infants:a randomized controlled pilot trial[J]. Arch Womens Ment Health,2011,14(4):317-324.
[24] Zelkowitz P, Feeley N, Shrier I, et al. The cues and care randomized controlled trial of a neonatal intensive care unit intervention:effects on maternal psychological distress and mother-infant interaction[J]. J Dev Behav Pediatr, 2011,32(8):591-599.
[25]刘会，张少媚，袁浩.认知行为干预对降低喂养不耐受早产儿父母负性情绪的影响[J].临床医药文献杂志，2019,6(25):122-123.
[26]李莹，孙一勤，陈三妹，等.认知行为干预对改善NICU患儿父母焦虑的影响[J].护理学报，2011,18(7A):74-75.
[27]王军霞.认知行为干预对重型颅脑损伤患儿家长心理应激及康复锻炼依从性的影响[J].白求恩医学杂志，2020,18(1):44-46.
[28] Logan GE, Sahrmann JM, Gu H, et al. Parental mental health care after their child’s pediatric intensive care hospitalization[J]. Pediatr Crit Care Med, 2020,21(11):941-948.
[29] Stremler R, Haddad S, Pullenayegum E, et al. Psychological outcomes in parents of critically ill hospitalized children[J]. J Pediatr Nurs, 2017,34(12):36-43.
[30] Simblett SK, Yates M, Wagner AP, et al. Computerized cognitive behavioral therapy to treat emotional distress after stroke:a feasibility randomized controlled trial[J]. JMIR Ment Health, 2017,4(2):e16.
[31] Zegarow P, Manczak M, Rysz J, et al. The influence of cognitive-behavioral therapy on depression in dialysis patients-meta-analysis[J]. Arch Med Sci, 2020,16(6):1271-1278.
[32] Li J, Li X, Jiang J, et al. The effect of cognitive behavioral therapy on depression, anxiety, and stress in patients with COVID-19:a randomized controlled trial[J]. Front Psychiatry, 2020,11:580827.
[33] Lau BHP, Chow AYM, Ng TK, et al. Comparing the efficacy of integrative body-mind-spirit intervention with cognitive behavioral therapy in patient-caregiver parallel groups for lung cancer patients using a randomized controlled trial[J]. J Psychosoc Oncol, 2020,38(4):389-405.
[34] Losada A, Márquez-González M, Romero-Moreno R,et al. Cognitive-behavioral therapy(CBT)versus acceptance and commitment therapy(ACT)for dementia family caregivers with significant depressive symptoms:Results of a randomized clinical trial[J]. J Consult Clin Psychol, 2015,83(4):760-772.
[35] Esposito-Smythers C, Wolff JC, Liu RT, et al. Familyfocused cognitive behavioral treatment for depressed adolescents in suicidal crisis with co-occurring risk factors:a randomized trial[J]. J Child Psychol Psychiatry,2019,60(10):1133-1141.
[36] Martin CG, Everett Y, Skowron EA, et al. The role of caregiver psychopathology in the treatment of childhood trauma with trauma-focused cognitive behavioral therapy:a systematic review[J]. Clin Child Fam Psychol Rev,2019,22(3):273-289.
[37] Szigethy E, Weisz JR, Findling RL.儿童与青少年认知行为疗法[M].北京：中国轻工业出版社，2014.
[38] Haynes PL, Burger SB, Kelly M, et al. Cognitive behavioral social rhythm group therapy versus present centered group therapy for veterans with posttraumatic stress disorder and major depressive disorder:a randomized controlled pilot trial[J]. J Affect Disord, 2020,277:800-809.
[39] Kameoka S, Tanaka E, Yamamoto S, et al. Effectiveness of trauma-focused cognitive behavioral therapy for Japanese children and adolescents in community settings:a multisite randomized controlled trial[J]. Eur J Psychotraumatol, 2020,11(1):1767987.
[40] Smith AM, Stewart K, Baul T, et al. Peer delivery of a brief cognitive-behavioral treatment for posttraumatic stress disorder:a hybrid effectiveness-implementation pilot study[J]. J Clin Psychol, 2020,76(12):2133-2154.
[41] Kananian S, Soltani Y, Hinton D, et al. Culturally adapted cognitive behavioral therapy plus problem management(CA-CBT+)with afghan refugees:a randomized controlled pilot study[J]. J Trauma Stress,2020,33(6):928-938.
[42] Wu Q, Li J, Parrott S, et al. Cost-effectiveness of different formats for delivery of cognitive behavioral therapy for depression:a systematic review based economic model[J]. Value Health, 2020,23(12):1662-1670.
[43] Zegarow P, Manczak M, Rysz J, et al. The influence of cognitive-behavioral therapy on depression in dialysis patients-meta-analysis[J]. Arch Med Sci, 2020,16(6):1271-1278.
基本信息:
DOI：10.19757/j.cnki.issn1674-7763.2023.01.009
中图分类号:R473.72
引用信息:
[1]刘桂华,林锦玲,郑清香等.认知行为疗法对重症患儿家属心理健康影响的系统评价和meta分析[J].中国妇幼卫生杂志,2023,14(01):43-50.DOI:10.19757/j.cnki.issn1674-7763.2023.01.009.
基金信息:
2020年福建省科技创新联合资金项目（2020Y9030）