社会心理干预对减重手术患者健康状况影响的系统评价

doi:10.3761/j.issn.0254-1769.2023.23.015

摘要/Abstract

摘要：

目的系统评价社会心理干预对减重手术患者健康状况的干预效果。方法计算机检索PubMed、Web of Science、Embase、Cochrane Library、Clinic Trials、PsycInfo、中国生物医学文献数据库、中国知网、万方数据库、维普数据库以及中外临床试验注册中心，检索社会心理干预对减重手术患者健康状况影响的随机对照试验，检索时限均为从建库至2022年9月15日。由2名研究者进行质量评价，采用RevMan 5.3软件进行Meta分析。结果共纳入23项研究，Meta分析结果显示，社会心理干预能改善患者情绪化饮食和暴饮暴食行为[SMD=-0.44，95%CI（-0.78，-0.09），P=0.010；MD=-5.88，95%CI（-8.65，-3.11），P<0.001]，提高患者的生活质量[SMD=0.30，95%CI（0.02，0.59），P=0.040]，缓解患者的焦虑和抑郁情绪[SMD=-0.37，95%CI（-0.67，-0.08），P=0.010；SMD=-0.59，95%CI（-0.84，-0.33），P<0.001]，但在改善进食障碍方面效果不明显，差异无统计学意义[MD=-0.01，95%CI（-0.19，0.18），P=0.950]。不同干预措施和随访时间的亚组分析结果显示，试验组与对照组在体重变化方面差异无统计学意义（P>0.05）。结论社会心理干预能改善减重手术患者的心理状态及饮食行为，提高患者的生活质量，但在进食障碍和体重变化方面干预效果尚不明确，仍需开展更多高质量的临床研究进一步验证。

关键词: 社会心理干预, 减重手术, 健康状况, Meta分析, 循证护理学

Abstract:

Objective To systematically evaluate the intervention effect of social psychological intervention on the health status of patients with bariatric surgery（BS）. Methods 8 databases，including PubMed，PsycInfo，and Embase and Clinic Trials，were retrieved to recruit randomized controlled trials with computer from database establishing time to Sep. 2022. Independent quality evaluation was conducted by 2 researchers，and Meta-analysis was performed by the RevMan5.3 software. Results Totally 23 RCTs were included. The meta-analysis showed that psychosocial interventions in BS patients improve emotional eating and binge eating behavior[SMD=-0.44，95%CI（-0.78，-0.09），P=0.010；MD=-5.88，95%CI（-8.65，-3.11），P<0.001]，promote better quality of life[SMD=0.30，95%CI（0.02，0.59），P=0.040] and physical mobility，alleviates anxiety and depression[SMD=-0.37，95%CI（-0.67，-0.08），P=0.010；SMD=-0.59， 95%CI（-0.84，-0.33），P<0.001]. However，the effect on improving eating disorders[MD=-0.01，95%CI（-0.19，0.18），P=0.950] is not significant，and subgroup analysis results of different intervention measures and follow-up times showed that there was no statistically significant difference in weight changes between the social psychological intervention group and the control group. Conclusion Psychosocial intervention can effectively improve the mental state and eating behavior of the bariatric surgery patients，improve the quality of life and increase physical activity of patients. However，the effect of intervention on eating disorder and weight change is still unclear. More high-quality clinical studies need to be carried out for further verification.

Key words: Psychological Intervention, Bariatric Surgery, Health Status, Meta-Analysis, Evidence-Based Nursing

詹晓庆, 郑喜兰, 王继伟, 杨念, 蔡久梅, 任敏敏, 谢铭. 社会心理干预对减重手术患者健康状况影响的系统评价[J]. 中华护理杂志, 2023, 58(23): 2920-2927.

ZHAN Xiaoqing, ZHENG Xilan, WANG Jiwei, YANG Nian, CAI Jiumei, REN Minmin, XIE Ming. Psychosocial intervention for improving health in patients with bariatric surgery：a Meta-analysis[J]. Chinese Journal of Nursing, 2023, 58(23): 2920-2927.

图/表 3

图1 文献筛选流程图

Figure 1 Literature screening flow chart

表1 纳入文献的基本特征（n=23）

Table 1 Descriptive characteristics of the included studies（n=23）

图2 社会心理干预对减重手术患者BMI影响的漏斗图

Figure 2 Funnel plot of the impact of social psychological intervention methods on BMI

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