Meta-analysis of the effects of psychoeducational care in adults with chronic obstructive pulmonary disease
Meta-analysis of the effects of psychoeducational care in adults with chronic obstructive pulmonary disease
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DOI：
10.1016/0738-3991(96)00862-2
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发表时间：
1996-11-01
影响因子：
3.5
通讯作者：
Pearcy, J
中科院分区：
文献类型：
--
作者：
Devine, EC;Pearcy, J
荟萃分析是一项定量研究综述，对 65 项关于教育、锻炼和/或社会心理支持（以下称为心理教育护理）对患有慢性阻塞性肺病 (COPD) 的成人患者的影响的研究进行了分析。研究的发表日期为 1954 年至 1994 年。只有 34% 的研究将受试者随机分配到治疗条件，只有 15% 的研究有安慰剂型对照组。按治疗类型进行的分析表明，肺康复（大肌肉锻炼和教育加上各种社会心理或行为干预）对心理健康（d(+)=0.58，n=13）、耐力（d（+）=0.771 n=13）、功能状态（d（+）=0.63，n=8）、摄氧量（d（+）=0.56，n=5）、呼吸困难具有统计学上显着的有益影响(d(+)=0.71，n=10)，以及依从性(d(+)=1.76，n=2)。未发现肺康复对 1 秒用力呼气量有统计学上显着的有益作用。在检查的 7 个结果中，包括单独教育在内的治疗仅对执行吸入器技能的准确性产生显着的有益影响 (d(+)=1.27，n=7）。基于非常小的研究样本，仅教育对医疗保健利用（d（+）= 0.26，n = 3）和治疗方案依从性（d（+）= 0.50，n = 2）有明显的不显着但中小影响。这些结果尚无定论，表明可能需要进一步研究。单独放松对呼吸困难（d(+)=0.91，n=3）和心理健康（d(+)=0.39，n=6）具有统计学上显着的有益效果。该研究基础存在方法上的弱点，应在未来的研究中予以纠正。尽管如此，根据迄今为止最好的证据，已确定的心理教育护理类型已被证明可以改善患有慢性阻塞性肺病的成年人的功能和福祉。
Meta-analysis, a quantitative research review, was conducted on 65 studies of the effect of education, exercise and/or psychosocial support (hereafter called psychoeducational care) in adults with chronic obstructive pulmonary disease (COPD). Studies ranged in publication date from 1954 to 1994. Only 34% of studies had subjects that were randomly assigned to treatment condition, and only 15% of studies had a placebo-type control group. Analyses by type of treatment showed that pulmonary rehabilitation (large muscle exercise and education plus a variety of psychosocial or behavioral interventions) had statistically significant beneficial effects on psychological well-being (d(+)=0.58, n=13), endurance (d(+)=0.771 n=13), functional status (d(+)=0.63, n=8), VO2 (d(+)=0.56, n=5), dyspnea (d(+)=0.71, n=10), and adherence (d(+)=1.76, n=2). A statistically significant beneficial effect of pulmonary rehabilitation was not found on Forced Expiratory Volume at 1 s. Across 7 outcomes examined, treatments including education-alone had significant beneficial effect only on the accuracy of performing inhaler skills (d(+)=1.27, n=7). Based on a very small sample of studies, a non-significant but small or medium sized effect of education-alone was evident on health care utilization (d(+)=0.26, n=3) and on adherence to treatment regimen (d(+)=0.50, n=2). Such results are inconclusive, suggesting that further research may be indicated. Relaxation-alone had statistically significant beneficial effects on both dyspnea (d(+)=0.91, n=3) and psychological well-being (d(+)=0.39, n=6). The research base has methodological weaknesses that should be rectified in future research. Nonetheless, based on the best evidence available to date, identified types of psychoeducational care have been shown to improve the functioning and well-being of adults with COPD.