【摘要】：目的:通過比較不同心理干預方法在減輕惡性腫瘤患兒負性情緒方面的干預效果,明確其最優(yōu)的心理干預方法。方法:采用計算機檢索臨床對照試驗中心注冊數(shù)據(jù)庫(Cochrane Central of Registration Controlled Trials,CENTRAL)、荷蘭醫(yī)學文摘數(shù)據(jù)庫(Excerpta Medical Datebase,EMBASE)、Pub Med、科學引文索引(Web of Science,WEB)、中國生物醫(yī)學文獻數(shù)據(jù)庫(China Biomedical Literature Database,CBM)、中國知網(wǎng)(China National Knowledge Infrastructure,CNKI)、維普數(shù)據(jù)庫(VIP Datebase,VIP)和萬方數(shù)據(jù)庫(Wan Fang Database,WF)中有關不同心理干預方法對惡性腫瘤患兒負性情緒干預效果的隨機對照研究,檢索時間均為建庫至2017年2月。納入比較不同心理干預方法對惡性腫瘤患兒負性情緒影響的隨機對照試驗,由2名評價人員按照標準獨立篩選文獻、提取資料、評價文獻質(zhì)量。用STATA 14.0軟件進行網(wǎng)狀Meta分析。結果:共納入24篇文獻。網(wǎng)狀Meta分析結果顯示,與普通心理干預療法相比,音樂療法(SMD=0.69,95%CI=0.17~1.21)、游戲療法(SMD=0.74,95%CI=0.45~1.03)、認知行為療法(SMD=4.32,95%CI=2.42~6.58)、心理健康教育療法(SMD=0.63,95%CI=0.14~1.13)在減輕惡性腫瘤患兒負性情緒方面效果差異有統(tǒng)計學意義(均P0.05);與其他6種心理干預方法相比,認知行為療法在減輕惡性腫瘤患兒負性情緒方面的效果差異有統(tǒng)計學意義,其中與音樂療法相比(SMD=-3.63,95%CI=-5.60~-1.66);與游戲療法相比(SMD=-3.58,95%CI=-5.51~-1.66);與游戲結合音樂與閱讀的混合型療法(SMD=-4.00,95%CI=-5.95~-2.05);與心理健康教育療法相比(SMD=-3.69,95%CI=-5.65~-1.73);與普通心理療法相比(SMD=-4.32,95%CI=-6.22~-2.42);與圖書閱讀療法相比(SMD=-4.60,95%CI=-6.58~-2.61)(均P0.05)。結論:7種心理干預方法累積排序概率圖下面積值從低到高的排序依次為:認知行為療法、游戲療法、音樂療法、混合型療法、心理健康教育療法、普通心理干預療法、圖書閱讀療法,因此,認知行為療法是減輕惡性腫瘤患兒負性情緒的最優(yōu)心理干預方法,能提高患兒依從性及心理應對能力,改善其遠期生存質(zhì)量。
[Abstract]:Objective: to compare the effects of different psychological intervention methods on alleviating negative emotion in children with malignant tumor and to find out the best psychological intervention method. Methods: the registered database (Cochrane Central of Registration Controlled Trials,CENTRAL) and the scientific citation index (Web of Science,WEB) of the Netherlands Medical Abstract Database (Excerpta Medical Datebase,EMBASE), Pub Med,) were searched by computer. (China Biomedical Literature Database,CBM, (China National Knowledge Infrastructure,CNKI, VIP Datebase,VIP and (Wan Fang Database, A randomized controlled study on the effects of different psychological intervention methods on negative emotion intervention in children with malignant tumor was conducted in WF. The retrieval time of these two methods was established until February 2017. A randomized controlled trial was conducted to compare the influence of different psychological intervention methods on negative emotion in children with malignant tumor. Two evaluators independently screened the literature according to the standard, extracted the data and evaluated the quality of the literature. The net Meta was analyzed by STATA 14.0 software. Results: a total of 24 articles were included. The results of reticular Meta analysis showed that music therapy (SMD=0.69,95%CI=0.17~1.21), game therapy (SMD=0.74,95%CI=0.45~1.03), cognitive behavioral therapy (SMD=4.32,95%CI=2.42~6.58) were compared with common psychological intervention therapy. The effect of mental health education therapy (SMD=0.63,95%CI=0.14~1.13) on relieving negative emotion in children with malignant tumor was significantly different (P0.05). Compared with the other six psychological intervention methods, there were significant differences in the effect of cognitive behavioral therapy in relieving negative emotion in children with malignant tumor, including music therapy (SMD=-3.63,95%CI=-5.60~-1.66). Compared with game therapy (SMD=-3.58,95%CI=-5.51~-1.66), combined therapy with music and reading (SMD=-4.00,95%CI=-5.95~-2.05); Compared with mental health education therapy (SMD=-3.69,95%CI=-5.65~-1.73), general psychotherapy (SMD=-4.32,95%CI=-6.22~-2.42); Compared with book reading therapy (SMD=-4.60,95%CI=-6.58~-2.61) (P0.05). Conclusion: the order of the area values under the cumulative sequence probability map of 7 psychological intervention methods is: cognitive behavior therapy, game therapy, music therapy, mixed therapy, mental health education therapy, general psychological intervention therapy, the order of which is: cognitive behavior therapy, game therapy, music therapy, mixed therapy, mental health education therapy and general psychological intervention therapy. Therefore, cognitive behavior therapy is the best psychological intervention method to alleviate negative emotion in children with malignant tumor. It can improve children's compliance and psychological coping ability, and improve their long-term quality of life.
【作者單位】： 重慶醫(yī)科大學兒科學院兒童發(fā)育疾病研究教育部重點實驗室兒童發(fā)育重大疾病國家國際科技合作基地兒科學重慶市重點實驗室;重慶醫(yī)科大學附屬兒童醫(yī)院特需門診;
【基金】：重慶市科學技術委員會資助項目(編號:cstc2016shmszx0571) 2013-2014年度國家臨床護理重點專科建設資助項目(編號:國衛(wèi)辦醫(yī)涵[2013]544號)
【分類號】：R473.73

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