Psychological interventions for rheumatoid arthritis: A meta-analysis of randomized controlled trials
Psychological interventions for rheumatoid arthritis: A meta-analysis of randomized controlled trials
复制标题
DOI：
10.1002/art.10416
复制
发表时间：
2002-06-15
期刊：
影响因子：
--
通讯作者：
Berman, B
中科院分区：
文献类型：
--
作者：
Astin, JA;Beckner, W;Berman, B
客观的。对研究心理干预（例如放松、生物反馈、认知行为疗法）治疗类风湿关节炎（RA）疗效的文献进行系统回顾。方法。符合以下标准的研究包括：随机分配、候补名单或常规护理控制条件；在同行评审期刊上发表文章；除了提供教育信息之外，治疗还包括一些心理成分；如果包括患有 RA 以外疾病的受试者，则为 RA 患者提供单独的数据。两名研究人员独立提取有关研究设计、样本量和特征、干预类型、控制类型、结果的方向和性质的数据。结果。二十五个试验符合纳入标准。评估了方法学质量，并计算了 6 个结果的效应大小。干预后发现疼痛（0.22）、功能障碍（0.27）、心理状态（0.15）、应对（0.46）和自我效能（0.35）的合并效应显着。随访时（平均 8.5 个月），关节压痛 (0.33)、心理状态 (0.30) 和应对方式 (0.52) 观察到显着的合并效应大小。当比较不同类型的治疗和对照条件的效应大小时，或者当将较高质量的试验与较低质量的试验进行比较时，没有出现清晰或一致的模式。然而，研究结果确实表明，这些心理干预措施对于患病时间较短的患者可能更有效。结论。尽管文献中存在一些方法学缺陷，但心理干预可能是 RA 医疗管理中重要的辅助疗法。
Objective. To carry out a systematic review of the literature examining the efficacy of psychological interventions (e.g., relaxation, biofeedback, cognitive-behavioral therapy) in the treatment of rheumatoid arthritis (RA).Methods. Studies that met the following criteria were included: random assignment, wait-list or usual care control condition; publication in peer-reviewed journals; treatment that included some psychological component beyond simply providing education information; and separate data provided for patients with RA if subjects with conditions other than RA were included. Two investigators independently extracted data on study design, sample size and characteristics, type of intervention, type of control, direction and nature of the outcome(s).Results. Twenty-five trials met the inclusion criteria. Methodologic quality was assessed, and effect sizes were calculated for 6 outcomes. Significant pooled effect sizes were found postintervention for pain (0.22), functional disability (0.27), psychological status (0.15), coping (0.46), and self efficacy (0.35). At followup (averaging 8.5 months), significant pooled effect sizes were observed for tender joints (0.33), psychological status (0.30), and coping (0.52). No clear or consistent patterns emerged when effect sizes for different types of treatment and control conditions were compared, or when higher quality trials were compared to lower quality ones. Findings do, however, suggest that these psychological interventions may be more effective for patients who have had the illness for shorter duration.Conclusions. Despite some methodologic flaws in the literature, psychological interventions may be important adjunctive therapies in the medical management of RA.