心力衰竭患者的认知行为疗法的临床影响:随机对照试验的元分析
Mahmoud Balata1, Mohamed Ibrahim Gbreel2, Asmaa Ahmed Elrashedy3
1Department of Internal Medicine and Polyclinic II, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. dr.mahmoud.balata@gmail.com.
BMC complementary medicine and therapies
|August 7, 2023
概括
认知行为疗法 (CBT) 显著降低了心力衰竭 (HF) 患者长期的抑郁和焦虑. 短期CBT对HF患者的自我护理,抑郁或焦虑没有显著影响.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 行为科学 行为科学
背景情况:
- 心力衰竭 (HF) 患者的抑郁率为20-40%,明显高于一般人群.
- 在HF患者中,抑郁症与不良结果有关,包括增加死亡率和住院治疗.
研究的目的:
- 评估认知行为疗法 (CBT) 在治疗心力衰竭 (HF) 患者抑郁和焦虑症状方面的有效性.
- 评估CBT对心力衰竭患者自我护理实践的影响.
主要方法:
- 在PubMed,科学网,Scopus和Cochrane图书馆进行了系统的文献搜索,截至2022年10月15日.
- 七个随机对照试验 (RCT) 涉及611名患者被纳入了分析.
- 用Review Manager软件 (RevMan 5.4) 提取和分析数据,将连续数据作为 95% 置信区间的平均差异汇总在一起.
主要成果:
- 认知行为疗法 (CBT) 在4-6个月 (MD = -4.87) 和8-9个月 (MD = -5.71) 随访后显著降低了贝克抑郁 inventory-II (BDI-II) 评分.
- 在3个月的随访期间,BDI-II得分没有显著下降 (MD = -4.34).
- 还评估了二次结果,包括焦虑和自我护理措施,并指出对焦虑的长期益处.
结论:
- 认知行为疗法 (CBT) 在减少心力衰竭患者焦虑和抑郁症状方面提供了显著的长期益处 (4-9个月).
- 短期 (不到3个月) 的CBT干预并没有显著影响该患者群体的自我护理,抑郁或焦虑.
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