Effectiveness of theory-based digital self-management interventions for improving depression, anxiety, fatigue and self-efficacy in people with neurological disorders: A systematic review and meta-analysis.
Effectiveness of theory-based digital self-management interventions for improving depression, anxiety, fatigue and self-efficacy in people with neurological disorders: A systematic review and meta-analysis.
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DOI：
10.1177/1357633x20955122
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发表时间：
2022-09
影响因子：
4.7
通讯作者：
Wong AW
中科院分区：
文献类型：
--
作者：
Lau SC;Bhattacharjya S;Fong MW;Nicol GE;Lenze EJ;Baum C;Hardi A;Wong AW
本研究旨在 (a) 回顾哪些理论已应用于开发针对神经系统疾病患者的数字自我管理干预措施； (b) 检查其改善抑郁、焦虑、疲劳和自我效能的有效性； (c) 确定干预实施的最佳模式。检索了电子数据库（SCOPUS、MEDLINE、EMBASE、CINAHL、Cochrane Library 和 ClinicalTrials.gov）。两名研究人员独立筛选研究并提取数据。还评估了研究质量和理论应用。共筛选了 944 项研究，其中纳入了 16 项随机对照试验。基于理论的数字自我管理干预措施可有效减少抑郁（标准化均数差（SMD）= -0.77，95%置信区间（CI）-1.04至-0.49）、焦虑（SMD = -0.88，95% CI -1.54至-0.21）和疲劳（SMD = -0.62，95% CI -0.96至-0.27）并增强自我效能（SMD = 1.15，95% CI 0.11–2.18）。基于认知行为理论（CBT）的干预措施可有效减少抑郁（SMD = -0.81，95% CI -1.22至-0.39）、焦虑（SMD = -1.15，95% CI -1.85至-0.44）和疲劳（SMD = -0.75，95% CI -0.97至-0.54）并提高自我效能（SMD = 0.84，95% CI 0.63–1.05），而基于社会认知理论（SCT）的干预措施可有效减少抑郁症（SMD = -0.73，95% CI -1.17 至 -0.28）。部分数字化干预比完全数字化干预更有效。我们的研究结果支持使用理论来指导数字自我管理干预措施的发展，以提高干预效果。特别是，基于 CBT 的干预措施对抑郁、焦虑、疲劳和自我效能有积极影响，而基于 SCT 的干预措施对抑郁有积极影响。
This study aimed to (a) review what theories have been applied to the development of digital self-management interventions for people with neurological disorders; (b) examine their effectiveness to improve depression, anxiety, fatigue and self-efficacy; and (c) identify the optimal mode of intervention delivery. Electronic databases (SCOPUS, MEDLINE, EMBASE, CINAHL, Cochrane Library and Clinicaltrials.gov) were searched. Two investigators independently screened studies and extracted data. Study quality and use of theory were also assessed A total of 944 studies were screened, and 16 randomised controlled trials were included. Theory-based digital self-management interventions were effective in reducing depression (standardised mean difference (SMD) = −0.77, 95% confidence interval (CI) −1.04 to −0.49), anxiety (SMD = −0.88, 95% CI −1.54 to −0.21) and fatigue (SMD = −0.62, 95% CI −0.96 to −0.27) and in enhancing self-efficacy (SMD = 1.15, 95% CI 0.11–2.18). Cognitive–behavioural theory (CBT)-based interventions were effective in reducing depression (SMD = −0.81, 95% CI −1.22 to −0.39), anxiety (SMD = −1.15, 95% CI −1.85 to −0.44) and fatigue (SMD = −0.75, 95% CI −0.97 to −0.54) and in improving self-efficacy (SMD = 0.84, 95% CI 0.63–1.05), whereas social cognitive theory (SCT)-based interventions were effective in reducing depression (SMD = −0.73, 95% CI −1.17 to −0.28). Partially digital interventions were more effective than fully digital interventions. Our findings support the use of theory to guide the development of digital self-management interventions to increase intervention effectiveness. In particular, CBT-based interventions have a positive impact on depression, anxiety, fatigue and self-efficacy, whereas SCT-based interventions have a positive impact on depression.