Meta-analysis of the effect of psychoeducational interventions on pain in adults with cancer.
Meta-analysis of the effect of psychoeducational interventions on pain in adults with cancer.
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DOI：
10.1188/03.onf.75-89
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发表时间：
2003-01-01
影响因子：
1.9
通讯作者：
Devine, Elizabeth C
中科院分区：
文献类型：
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作者：
Devine, Elizabeth C
目的/目的：资料来源：1978- 2001年发表的25项心理教育干预研究。资料综合：对所有研究进行分析时，发现心理教育干预对疼痛有统计学意义的有益效果，但也有一些研究存在有效性威胁。其中最严重的涉及缺乏治疗条件的随机分配和对疼痛的地板效应。当仅限于具有最佳方法学质量的研究时，对疼痛的影响仍然具有统计学显著性。对疼痛的治疗类型的影响进行了检查，发现有点变量和测试每种类型的treatment.CONCLUSIONS：方法质量是可变的研究数量少的限制。合理的强有力的证据存在放松为基础的认知行为干预，教育有关镇痛药的使用，和支持性咨询。关于不同类型的心理教育干预措施的相对有效性的数据很少，因为很少有研究包括不同的实验干预措施和通常的护理研究内的对比没有很好的documented.IMPLICATIONS为observing：心理教育干预措施是不是止痛药的替代品，但它们可以作为辅助治疗。评估和临床判断至关重要。干预必须是患者可接受的，并且不会给疼痛患者带来太大负担。
PURPOSE/OBJECTIVES: To determine the effect of psychoeducational interventions on pain in adults with cancer.DATA SOURCES: 25 intervention studies published from 1978-2001.DATA SYNTHESIS: When analyzed across all studies, a statistically significant, beneficial effect on pain was found. However, threats to validity were present in some studies. The most serious of these involved a lack of random assignment to treatment condition and a floor effect on pain. When limited to the studies with the best methodologic quality, the effect on pain continued to be statistically significant. Effect on pain by type of treatment was examined and found to be somewhat variable and limited by the small number of studies testing each type of treatment.CONCLUSIONS: Methodologic quality was variable. Reasonably strong evidence exists for relaxation-based cognitive-behavioral interventions, education about analgesic usage, and supportive counseling. Minimal data were available about the relative effectiveness of different types of psychoeducational interventions because few studies included within-study contrasts of different experimental interventions and usual care was not well documented.IMPLICATIONS FOR NURSING: Psychoeducational interventions are not a substitute for analgesics, but they may serve as adjuvant therapy. Assessment and clinical judgment are critical. The intervention must be acceptable to patients and not too burdensome for patients in pain to use.