抑郁症相关失眠症成年患者的经历:定性系统综述。

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES JBI evidence synthesis Pub Date : 2024-09-09 DOI:10.11124/JBIES-23-00499
Sanne T Kristiansen, Cecilie N Lyhne, Mette Kragh, Karen R Sigaard, Poul Videbech, Erik R Larsen, Merete B Bjerrum
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引用次数: 0

摘要

目的:本综述旨在确定和综合现有的最佳证据,以了解成年患者如何经历与抑郁症相关的失眠,以及他们与旨在改善睡眠的药物和非药物干预措施相关的经历:失眠影响着 80% 至 90% 的抑郁症患者。失眠对个人和社会造成的代价都是巨大的。要了解失眠对抑郁症患者的作用和后果,并优化睡眠干预措施,就需要深入了解患者的经历。因此,本综述探讨了成年患者如何体验与抑郁相关的失眠,以及抑郁相关失眠患者接受药物和非药物睡眠干预的经历:纳入标准:以年龄在 18 岁及以上、诊断为抑郁症的成年患者为研究对象,这些患者有失眠和药物及/或非药物睡眠干预的经历。所有从住院病人和门诊病人中得出定性研究结果的研究均在考虑之列:检索了以下数据库:MEDLINE(PubMed)、Embase(Elsevier)、CINAHL(EBSCOhost)、PsycINFO(ProQuest)、Cochrane CENTRAL、SveMed+、Scopus 和 Web of Science Core Collection。在 Google Scholar 和 ProQuest Dissertations and Theses 中检索了符合条件的论文。搜索时间为 2022 年 5 月 3-5 日,更新时间为 2023 年 6 月 13-19 日。以英语、丹麦语、德语、挪威语和瑞典语发表的研究均在考虑之列。数据库的检索时间为数据库建立至检索日期。所有研究均按照纳入标准进行筛选,并由两名评审员独立对研究的方法学质量进行严格评审。使用元聚合法对研究结果进行汇总,并创建了 ConQual 研究结果摘要:结果:共纳入 10 项定性研究。这些研究在 6 个国家进行,共有 176 人参与。总共提取了 127 项研究结果,并将其归纳为 11 个类别。从这 11 个类别中,得出了 3 个综合结论:1)睡眠中断会耗尽身体和精神资源,从而给应对日常生活带来挑战;2)睡眠是一种逃避,也是防止自杀的保护因素;3)通过非药物方法解决抑郁症相关失眠问题的选择、支持和个性化干预措施很有价值:本综述强调了抑郁症相关失眠症之间的关系、其对个人生活的深远影响以及非药物睡眠干预对解决这些问题的价值。具体而言,该研究揭示了失眠对身体和情感造成的后果,同时强调了夜间易醒可能会加剧孤独感以及产生消极想法和自杀的可能性。此外,该研究还概述了患者采用非药物方法治疗抑郁症相关失眠症的经验,并强调了他们不同的治疗经验和偏好:本综述的丹麦语摘要可作为补充数字内容[http://links.lww.com/SRX/A64]获取。系统综述注册号:系统综述注册号:PROCROPERCO CRD42021276048。
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Experiences of adult patients living with depression-related insomnia: a qualitative systematic review.

Objective: The objective of this review was to identify and synthesize the best available evidence on how adult patients experience living with depression-related insomnia, and their experiences related to pharmacological and non-pharmacological interventions aimed at improving sleep.

Introduction: Insomnia affects 80% to 90% of patients with depression. The costs of insomnia are considerable for the individual and society alike. To understand the role and consequences of insomnia for an individual with depression and to optimize sleep interventions, an in-depth understanding of patients' experiences is needed. Therefore, this review addresses how adult patients experience living with depression-related insomnia, along with the experiences of pharmacological and non-pharmacological sleep interventions among patients with depression-related insomnia.

Inclusion criteria: Studies focusing on adult patients aged 18 years and older with a diagnosis of depression who had experiences with insomnia and pharmacological and/or non-pharmacological sleep interventions were included. All studies with qualitative research findings from inpatient and outpatient populations were considered.

Methods: The following databases were searched: MEDLINE (PubMed), Embase (Elsevier), CINAHL (EBSCOhost), PsycINFO (ProQuest), Cochrane CENTRAL, SveMed+, Scopus, and Web of Science Core Collection. Google Scholar and ProQuest Dissertations and Theses were searched for eligible dissertations and theses. The searches were conducted on May 3-5, 2022, and updated on June 13-19, 2023. Studies published in English, Danish, German, Norwegian, and Swedish were considered. Databases were searched from their inception to the search date. All studies were screened against the inclusion criteria and critically and independently appraised by 2 reviewers for methodological quality. Findings were pooled using meta-aggregation, and a ConQual Summary of Findings was created.

Results: Ten qualitative studies were included. The studies were conducted in 6 countries and counted a total of 176 participants. In all, 127 findings were extracted and aggregated into 11 categories. From the 11 categories, 3 synthesized findings were developed: 1) Disruption of sleep challenges coping with everyday life by depleting both physical and mental resources; 2) Sleep is an escape and a protective factor against suicide; and 3) Choices, support, and personalized interventions from non-pharmacological approaches addressing depression-related insomnia are valued.

Conclusions: This review underlined the relationship between depression-related insomnia, its profound impact on individuals' lives, and the value of non-pharmacological sleep interventions to address these issues. Specifically, the study revealed the physical and emotional consequences of insomnia while emphasizing how wakefulness during night hours may exacerbate feelings of loneliness and vulnerability to negative thoughts and suicide. Moreover, it provides an overview of patients' experiences of non-pharmacological approaches to address depression-related insomnia and highlights their diverse treatment experiences and preferences.

Supplemental digital content: A Danish-language version of the abstract of this review is available as Supplemental Digital Content [http://links.lww.com/SRX/A64].

Systematic review registration number: PROSPERO CRD42021276048.

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JBI evidence synthesis
JBI evidence synthesis Nursing-Nursing (all)
CiteScore
4.50
自引率
3.70%
发文量
218
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