摘要
目的系统评价优质护理对肺结节患者焦虑抑郁的改善效果,为进一步发挥优质护理在肺结节全程管理模式中的协同作用提供更高级别的循证医学证据。方法计算机检索CNKI、WanFang、VIP、SinoMed、PubMed、Embase、Web of Science数据库,筛选优质护理干预肺结节的随机对照试验(RCT),时间范围为建库至2024年7月28日;采用Cochrane偏倚风险评估工具对纳入研究进行质量评价;运用R软件(Version 4.3.3)的meta分析包进行meta分析。结果共纳入18项RCT,研究地区覆盖9个省份,总样本量2711例。meta分析结果显示,优质护理能够显著改善肺结节患者的焦虑状态[MD=-9.828,95%CI(-11.613,-8.043),P<0.001]、抑郁状态[MD=-10.873,95%CI(-14.232,-7.513),P<0.001]、疾病不确定感[MD=-28.892,95%CI(-46.441,-11.343),P=0.001],提高患者的生活质量[MD=8.232,95%CI(5.778,10.685),P<0.001]。敏感性分析显示优质护理的干预效果具有稳定性。但是系统评价提示,纳入研究存在较大的不确定风险,特别是在对于受试者和研究人员的盲法方面。结论优质护理能够显著改善肺结节患者的焦虑抑郁状态、疾病不确定感,提高患者的生活质量;但仍需未来在全国开展多中心、大样本、高质量的RCT进一步探索和验证。
Objective To systematically evaluate the im provement effect of excellent nurs ing care on the anxiety and depression in patients with pulmonary nodules,and to provide a higher level of evidence-based medical evidence for the synergistic effect of excellent nursing care on the whole management model of pulmonary nodules.Methods Computerized searches were conducted in databas es,including CNKI,WanFang,CQVIP,SinoMed,PubMed,Embase and Web of Science to identify randomized controlled trials(RCTs)on excellent nursing care intervention for pulmonary nod ules.The search period ranged from the conception of the databases to July 28,2024.The Cochrane bias risk assessment tool was employed for quality evaluation.Meta-analysis was performed using the meta analysis package with R software(Version 4.3.3).Results A total of 18 RCTs were included,covering 9 provinces in China,with a total sample size of 2711 cases.Meta-analysis indicated that excellent nursing care significantly alleviated the anxiety(MD=-9.828,95%CI[-11.613,-8.043],P<0.001),depression(MD=-10.873,95%CI[-14.232,-7.513],P<0.001),disease uncertainty(MD=-28.892,95%CI[-46.441,-11.343],P=0.001)in pulmonary nodule patients,and improved their quality of life(MD=8.232,95%CI[5.778,10.685],P<0.001).Sensitivity analyses demonstrated that the intervention effect of excellent nursing care was stable.However,the systematic evaluation suggested that there was a significant risk of uncertainty in the included studies,especially regarding blinding of participants and personnel.Conclusion Excellent nursing care could significantly improve anxiety,depression,disease uncertainty,and quality of life in pulmonary nodule patients.Further investigation and validation by future multi-center,large-sample,high-quality RCTs conducted nationwide are still required.
作者
李晏龙
姚衍竹
郑鑫泽
田妮
陈容
伍丽华
丘丽红
朱陈程
张欢
林洁涛
张思能
LI Yanlong;YAO Yanzhu;ZHENG Xinze;TIAN Ni;CHEN Rong;WU Lihua;QIU Lihong;ZHU Chencheng;ZHANG Huan;LIN Jietao;ZHANG Sineng(The First Clinical Medical School,Guangzhou University of Chinese Medicine,Guangdong,Guangzhou 510000,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong,Guangzhou 510000,China;School of Nursing,Chongqing Medical University,Chongqing 400000,China;School of Nursing,Guangzhou University of Chinese Medicine,Guangdong,Guangzhou 510000,China;Department of Thoracic Surgery,Sun Yat-Sen University Cancer Center,Guangdong,Guangzhou 510000,China;Department of General Thoracic Surgery,the First Affiliated Hospital of Anhui Medical University,Anhui,Hefei 230000,China;Department of Psychiatry,Zigong Hospital of Southwest Medical University(Zigong Mental Health Centre),Sichuan,Zigong 643000,China;Department of Oncology,Baiyun Hospital of the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong,Guangzhou 510000,China)
出处
《中国医药科学》
2025年第15期146-151,共6页
China Medicine And Pharmacy
基金
广州地区中西医协同临床重大创新技术建设项目(穗卫函〔2023〕2318号)。
关键词
优质护理
肺结节
焦虑
抑郁
系统评价
META分析
Excellent nursing care
Pulmonary nodules
Anxiety
Depression
Systematic review
Meta-analysis
