不同心理干预方法对恶性肿瘤患儿负性情绪干预效果的网状Meta分析

发布时间：2019-01-18 08:27

【摘要】：目的:通过比较不同心理干预方法在减轻恶性肿瘤患儿负性情绪方面的干预效果,明确其最优的心理干预方法。方法:采用计算机检索临床对照试验中心注册数据库(Cochrane Central of Registration Controlled Trials,CENTRAL)、荷兰医学文摘数据库(Excerpta Medical Datebase,EMBASE)、Pub Med、科学引文索引(Web of Science,WEB)、中国生物医学文献数据库(China Biomedical Literature Database,CBM)、中国知网(China National Knowledge Infrastructure,CNKI)、维普数据库(VIP Datebase,VIP)和万方数据库(Wan Fang Database,WF)中有关不同心理干预方法对恶性肿瘤患儿负性情绪干预效果的随机对照研究,检索时间均为建库至2017年2月。纳入比较不同心理干预方法对恶性肿瘤患儿负性情绪影响的随机对照试验,由2名评价人员按照标准独立筛选文献、提取资料、评价文献质量。用STATA 14.0软件进行网状Meta分析。结果:共纳入24篇文献。网状Meta分析结果显示,与普通心理干预疗法相比,音乐疗法(SMD=0.69,95%CI=0.17~1.21)、游戏疗法(SMD=0.74,95%CI=0.45~1.03)、认知行为疗法(SMD=4.32,95%CI=2.42~6.58)、心理健康教育疗法(SMD=0.63,95%CI=0.14~1.13)在减轻恶性肿瘤患儿负性情绪方面效果差异有统计学意义(均P0.05);与其他6种心理干预方法相比,认知行为疗法在减轻恶性肿瘤患儿负性情绪方面的效果差异有统计学意义,其中与音乐疗法相比(SMD=-3.63,95%CI=-5.60~-1.66);与游戏疗法相比(SMD=-3.58,95%CI=-5.51~-1.66);与游戏结合音乐与阅读的混合型疗法(SMD=-4.00,95%CI=-5.95~-2.05);与心理健康教育疗法相比(SMD=-3.69,95%CI=-5.65~-1.73);与普通心理疗法相比(SMD=-4.32,95%CI=-6.22~-2.42);与图书阅读疗法相比(SMD=-4.60,95%CI=-6.58~-2.61)(均P0.05)。结论:7种心理干预方法累积排序概率图下面积值从低到高的排序依次为:认知行为疗法、游戏疗法、音乐疗法、混合型疗法、心理健康教育疗法、普通心理干预疗法、图书阅读疗法,因此,认知行为疗法是减轻恶性肿瘤患儿负性情绪的最优心理干预方法,能提高患儿依从性及心理应对能力,改善其远期生存质量。
[Abstract]:Objective: to compare the effects of different psychological intervention methods on alleviating negative emotion in children with malignant tumor and to find out the best psychological intervention method. Methods: the registered database (Cochrane Central of Registration Controlled Trials,CENTRAL) and the scientific citation index (Web of Science,WEB) of the Netherlands Medical Abstract Database (Excerpta Medical Datebase,EMBASE), Pub Med,) were searched by computer. (China Biomedical Literature Database,CBM, (China National Knowledge Infrastructure,CNKI, VIP Datebase,VIP and (Wan Fang Database, A randomized controlled study on the effects of different psychological intervention methods on negative emotion intervention in children with malignant tumor was conducted in WF. The retrieval time of these two methods was established until February 2017. A randomized controlled trial was conducted to compare the influence of different psychological intervention methods on negative emotion in children with malignant tumor. Two evaluators independently screened the literature according to the standard, extracted the data and evaluated the quality of the literature. The net Meta was analyzed by STATA 14.0 software. Results: a total of 24 articles were included. The results of reticular Meta analysis showed that music therapy (SMD=0.69,95%CI=0.17~1.21), game therapy (SMD=0.74,95%CI=0.45~1.03), cognitive behavioral therapy (SMD=4.32,95%CI=2.42~6.58) were compared with common psychological intervention therapy. The effect of mental health education therapy (SMD=0.63,95%CI=0.14~1.13) on relieving negative emotion in children with malignant tumor was significantly different (P0.05). Compared with the other six psychological intervention methods, there were significant differences in the effect of cognitive behavioral therapy in relieving negative emotion in children with malignant tumor, including music therapy (SMD=-3.63,95%CI=-5.60~-1.66). Compared with game therapy (SMD=-3.58,95%CI=-5.51~-1.66), combined therapy with music and reading (SMD=-4.00,95%CI=-5.95~-2.05); Compared with mental health education therapy (SMD=-3.69,95%CI=-5.65~-1.73), general psychotherapy (SMD=-4.32,95%CI=-6.22~-2.42); Compared with book reading therapy (SMD=-4.60,95%CI=-6.58~-2.61) (P0.05). Conclusion: the order of the area values under the cumulative sequence probability map of 7 psychological intervention methods is: cognitive behavior therapy, game therapy, music therapy, mixed therapy, mental health education therapy, general psychological intervention therapy, the order of which is: cognitive behavior therapy, game therapy, music therapy, mixed therapy, mental health education therapy and general psychological intervention therapy. Therefore, cognitive behavior therapy is the best psychological intervention method to alleviate negative emotion in children with malignant tumor. It can improve children's compliance and psychological coping ability, and improve their long-term quality of life.
【作者单位】：重庆医科大学儿科学院儿童发育疾病研究教育部重点实验室儿童发育重大疾病国家国际科技合作基地儿科学重庆市重点实验室;重庆医科大学附属儿童医院特需门诊;
【基金】：重庆市科学技术委员会资助项目(编号:cstc2016shmszx0571) 2013-2014年度国家临床护理重点专科建设资助项目(编号:国卫办医涵[2013]544号)
【分类号】：R473.73

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