Do Psychosocial Interventions Improve Quality of Life and Wellbeing in Adults with Neuromuscular Disorders? A Systematic Review and Narrative Synthesis.
Do Psychosocial Interventions Improve Quality of Life and Wellbeing in Adults with Neuromuscular Disorders? A Systematic Review and Narrative Synthesis.
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DOI：
10.3233/jnd-160155
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发表时间：
2016-08-30
影响因子：
3.3
通讯作者：
Moss T
中科院分区：
文献类型：
--
作者：
Walklet E;Muse K;Meyrick J;Moss T
患有神经肌肉疾病的成年人的生活质量和幸福感经常受到限制。因此，确定适当的干预措施势在必行。本文的目的是系统地回顾和批判性地评价旨在改善成年神经肌肉疾病患者的生活质量和幸福感的心理社会干预的定量研究(随机对照试验、对照试验和队列研究)。对已发表和未发表的文献进行了系统的综述。使用有效的质量评估工具对符合纳入标准的研究进行评估，结果以叙述性综合的形式呈现。在确定的3136项研究中，有10项研究符合纳入审查的标准。纳入的研究包括一系列干预措施，包括：认知行为治疗、尊严治疗、催眠、表露、感恩清单、集体心理教育和心理知情康复。其中五项干预是针对肌萎缩侧索硬化症(ALS)患者的。其余的适用于脊髓灰质炎后综合症、肌肉营养不良和混合性疾病的患者，如夏科-玛丽-图斯病、重症肌无力和强直性肌营养不良。在不同的干预措施和神经肌肉疾病中，有七项研究报告了干预对生活质量和福祉的短期有益影响。虽然这些发现令人鼓舞，但这些研究的方法质量存在广泛的问题，严重影响了结果。由于这一领域缺乏高质量的研究，没有强有力的证据表明心理社会干预可以改善患有神经肌肉疾病的成年人的生活质量和幸福感。迫切需要具有积极对照、标准化结果测量和长期随访的多点随机对照试验。
Quality of life and well-being are frequently restricted in adults with neuromuscular disorders. As such, identification of appropriate interventions is imperative. The objective of this paper was to systematically review and critically appraise quantitative studies (RCTs, controlled trials and cohort studies) of psychosocial interventions designed to improve quality of life and well-being in adults with neuromuscular disorders. A systematic review of the published and unpublished literature was conducted. Studies meeting inclusion criteria were appraised using a validated quality assessment tool and results presented in a narrative synthesis. Out of 3,136 studies identified, ten studies met criteria for inclusion within the review. Included studies comprised a range of interventions including: cognitive behavioural therapy, dignity therapy, hypnosis, expressive disclosure, gratitude lists, group psychoeducation and psychologically informed rehabilitation. Five of the interventions were for patients with Amyotrophic Lateral Sclerosis (ALS). The remainder were for patients with post-polio syndrome, muscular dystrophies and mixed disorders, such as Charcot-Marie-Tooth disease, myasthenia gravis and myotonic dystrophy. Across varied interventions and neuromuscular disorders, seven studies reported a short-term beneficial effect of intervention on quality of life and well-being. Whilst such findings are encouraging, widespread issues with the methodological quality of these studies significantly compromised the results. There is no strong evidence that psychosocial interventions improve quality of life and well-being in adults with neuromuscular disorders, due to a paucity of high quality research in this field. Multi-site, randomised controlled trials with active controls, standardised outcome measurement and longer term follow-ups are urgently required.