心理教育干预:对系统分析的批判性回顾

Carmen W.H. Chan
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引用次数: 19

摘要

虽然许多作者推荐临床使用心理教育干预(PEI),但这些干预措施的性质差异很大,其有效性的证据远没有结论性。有必要对综述文章的质量进行批判性评价,以巩固有关PEI有效性的现有证据。目的对1985-2005年间发表的13篇关于PEI的综述文章进行综述。从以前的研究中发现了知识差距和经验教训,以指导未来的研究。方法采用系统的方法和明确的标准筛选13篇文献。使用清单对这些综述文章进行评价。检查表的项目包括目的、检索和纳入标准、定性评估、定量评估、差异、结果和结论以及评论。结果13篇综述共纳入809项初步研究。大多数综述对其搜索方法和纳入标准提供了清晰而全面的描述。在13项综述中,有10项综述提供了所审查研究的详细和充分的数据。8篇综述没有汇总或荟萃分析这些研究的结果。有证据表明,患者教育和渐进式肌肉放松(PMR)的有效性已被发现是积极的,并支持其临床应用。PEI的总体有效性尚无定论,因为研究了混合干预措施,并报告了显著和非显著的结果。建议未来进行大规模研究,重点关注一些常用的干预措施,如PMR、教育和咨询。特别考虑了未充分研究对象的选择,明确的干预和控制的选择,结果测量的选择和研究设计。
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Psychoeducational intervention: A critical review of systematic analyses

Background

While many authors recommend the clinical use of psychoeducational interventions (PEI), the nature of such interventions varies widely and evidence for their effectiveness far from conclusive. Critical appraisals of the quality of review articles are warranted to consolidate the available evidence on the effectiveness of PEI.

Objectives

This paper aims at critically reviewing 13 review articles of PEI that were published from 1985–2005. Knowledge gaps and lessons learnt from previous studies are identified to guide future studies.

Method

The 13 review articles were selected through a systematic approach and clearly defined criteria. A checklist was used for appraising these review articles. Items of the checklist included purpose, search and inclusion criteria, qualitative assessment, quantitative assessment, differences, results and conclusion, and comments.

Results

A total of 809 primary studies were included in the 13 reviews. Most reviews provided a clear and comprehensive description of their search methods and inclusion criteria. Ten out of thirteen reviews provided detailed and adequate data on the studies reviewed. Eight reviews did not pool or meta-analyze the results of these studies.

Discussion

There was evidence that the effectiveness of patient education and progressive muscle relaxation (PMR) has been found to be positive and there was support for their clinical use. The overall effectiveness of PEI was inconclusive because a mixture of interventions was studied and both significant and non-significant results had been reported. Future large-scale studies focusing on some commonly used interventions such as PMR, education, and counseling are recommended. Special consideration is given to the selection of understudied subjects, the selection of well-defined intervention and control, the selection of outcome measures and the research design.

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