Efficacy of Non-Pharmacological Interventions in Improving Health-Related Quality of Life in People Living With HIV: A Bayesian Network Meta-Analysis of Randomized Controlled Trials.

IF 5.3 2区医学 Q1 NURSING

Worldviews on Evidence-Based Nursing Pub Date : 2026-08-01 DOI:10.1111/wvn.70167

Mingyue Shi, Yunxian Zhou

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引用次数: 0

Abstract

Background: With antiretroviral therapy, HIV has become a manageable chronic condition, shifting focus to improving health-related quality of life (HRQoL). Non-pharmacological interventions offer distinct advantages for optimizing long-term health outcomes in people living with HIV.

Objectives: To identify optimal non-pharmacological interventions for improving overall HRQoL and its domains (physical, psychological, social, environmental, independence, spiritual).

Methods: Ten databases (Embase, MEDLINE, Web of Science Core Collection, CINAHL, PsycINFO, CENTRAL, CBM, CNKI, VIP Information, Wanfang Data) were searched from inception to August 2025. Bayesian network meta-analyzes were performed for direct and indirect comparisons. The Cochrane Rob-2 and the CINeMA tools were used to assess risk of bias and the certainty of evidence, respectively.

Results: 37 articles were included. Exercise was most effective for overall HRQoL (SMD = 1.00, 95% CI [0.43, 1.58]) and physical (SMD = 0.69, 95% CI [0.11, 1.27]), psychological (SMD = 0.93, 95% CI [0.37, 1.51]), and social (SMD = 0.57, 95% CI [0.06, 1.08]) domains. Mindfulness-based interventions ranked second for overall HRQoL (SMD = 0.82, 95% CI [0.24, 1.40]). Cognitive behavioral therapy ranked second in the psychological domain (SMD = 0.73, 95% CI [0.16, 1.29]). Insufficient data precluded network meta-analysis for environmental, independence, and spiritual domains.

Linking evidence to action: Future research should explore how different exercise types affect specific HRQoL dimensions and conduct large-scale, head-to-head RCTs to confirm the efficacy of exercise, cognitive behavioral therapy, and mindfulness interventions, especially for the environmental, independence, and spiritual domains. Methodological improvements-including blinding of outcome assessors, intention-to-treat analysis, standardized measurement tools, and protocol transparent reporting-are needed.

Trial registration: PROSPERO: CRD420251118087.

查看原文本刊更多论文

非药物干预改善HIV感染者健康相关生活质量的疗效：随机对照试验的贝叶斯网络meta分析

背景：通过抗逆转录病毒治疗，艾滋病毒已成为一种可控制的慢性疾病，将重点转移到改善与健康相关的生活质量（HRQoL）。非药物干预措施为优化艾滋病毒感染者的长期健康结果提供了明显的优势。目的：确定改善整体HRQoL及其领域（生理、心理、社会、环境、独立性、精神）的最佳非药物干预措施。方法：检索Embase、MEDLINE、Web of Science Core Collection、CINAHL、PsycINFO、CENTRAL、CBM、CNKI、VIP Information、万方数据等10个数据库，检索时间为建库至2025年8月。对直接和间接比较进行贝叶斯网络元分析。Cochrane rob2和CINeMA工具分别用于评估偏倚风险和证据的确定性。结果：纳入37篇文献。运动对整体HRQoL （SMD = 1.00, 95% CI[0.43, 1.58]）、身体（SMD = 0.69, 95% CI[0.11, 1.27]）、心理（SMD = 0.93, 95% CI[0.37, 1.51]）和社会（SMD = 0.57, 95% CI[0.06, 1.08]）领域最为有效。正念干预在总体HRQoL中排名第二（SMD = 0.82, 95% CI[0.24, 1.40]）。认知行为治疗在心理领域排名第二（SMD = 0.73, 95% CI[0.16, 1.29]）。由于数据不足，无法对环境、独立性和精神领域进行网络荟萃分析。将证据与行动联系起来：未来的研究应探索不同的运动类型如何影响特定的HRQoL维度，并进行大规模的头对头随机对照试验，以确认运动、认知行为疗法和正念干预的功效，特别是在环境、独立性和精神领域。方法上的改进——包括结果评估者的盲法、意向治疗分析、标准化的测量工具和透明的协议报告——是必要的。试验注册：PROSPERO: CRD420251118087。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Worldviews on Evidence-Based Nursing 医学-护理

CiteScore

6.10

自引率

11.60%

发文量

审稿时长

>12 weeks

期刊介绍： The leading nursing society that has brought you the Journal of Nursing Scholarship is pleased to bring you Worldviews on Evidence-Based Nursing. Now publishing 6 issues per year, this peer-reviewed journal and top information resource from The Honor Society of Nursing, Sigma Theta Tau International, uniquely bridges knowledge and application, taking a global approach in its presentation of research, policy and practice, education and management, and its link to action in real world settings. Worldviews on Evidence-Based Nursing is written especially for: Clinicians Researchers Nurse leaders Managers Administrators Educators Policymakers Worldviews on Evidence-Based Nursing is a primary source of information for using evidence-based nursing practice to improve patient care by featuring: Knowledge synthesis articles with best practice applications and recommendations for linking evidence to action in real world practice, administra-tive, education and policy settings Original articles and features that present large-scale studies, which challenge and develop the knowledge base about evidence-based practice in nursing and healthcare Special features and columns with information geared to readers’ diverse roles: clinical practice, education, research, policy and administration/leadership Commentaries about current evidence-based practice issues and developments A forum that encourages readers to engage in an ongoing dialogue on critical issues and questions in evidence-based nursing Reviews of the latest publications and resources on evidence-based nursing and healthcare News about professional organizations, conferences and other activities around the world related to evidence-based nursing Links to other global evidence-based nursing resources and organizations.