改善结核病患者治疗结果的心理社会支持干预措施:混合方法系统审查和元分析
Claire Maynard1, Shema Tariq1, Giovanni Sotgiu2
1UCL Institute for Global Health, UK.
EClinicalMedicine
|July 17, 2023
概括
心理社会支持干预措施通过解决多维障碍来改善结核病 (TB) 的结果. 有效的结核病治疗需要多方面的支持,心理干预表明有希望,但需要更多的证据来证明独立的有效性.
科学领域:
- 公共卫生和流行病学
- 医疗保健服务研究 医疗服务研究
- 卫生中的社会科学.
背景情况:
- 结核病 (TB) 患者在获得和参与护理方面遇到重大障碍.
- 将心理社会支持整合到以人为中心的模型中显示出改善结核病结果的潜力.
- 对结核病心理社会支持干预措施的有效性和最佳设计存在有限的共识.
研究的目的:
- 系统地审查和综合有关活跃结核病成年人心理社会支持干预措施的证据.
- 使用混合方法方法探索影响心理社会支持干预措施的有效性和上下文因素.
- 在国家结核病计划中,为设计和实施有效,当地适当的心理社会支持提供信息.
主要方法:
- 进行了混合方法系统审查,搜索了五个电子数据库 (2015年1月至2023年1月).
- 包括的研究包括随机对照试验,准实验试验,队列研究和定性研究.
- 采用了融合并行结果合成设计,通过融合编码矩阵集成定量和定性数据.
主要成果:
- 包括23项研究 (12种定量方法,10种定性方法,1种混合方法),主要来自高结核病负担,低收入和中等收入国家.
- 有效的干预措施提供多维的支持,包括物质和心理援助.
- 心理支持是变革性的,但目前的证据不足以证实它对治疗结果的独立影响.
结论:
- 干预措施的交付显著塑造了"护理逻辑"和患者体验.
- 复杂性视角突出了对特定环境,以人为中心的心理社会支持的需要.
- 研究结果为国家结核病计划中设计和实施心理社会支持提供了可操作的见解.
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