护士主导的自我护理干预对艾滋病病毒感染者生活质量、社会支持、抑郁和焦虑的影响：随机对照试验的系统回顾和荟萃分析。

IF 7.5 1区医学 Q1 NURSING

International Journal of Nursing Studies Pub Date : 2024-09-23 DOI:10.1016/j.ijnurstu.2024.104916

Haitao Huang , Xiaona Zhang , Ling Tu , Liao Zhang , Hong Chen

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引用次数: 0

摘要

背景：艾滋病病毒感染者通常面临着与生活质量、心理健康和社会支持相关的挑战。已经提出了以护士为主导的自我护理干预措施，作为解决这些问题的一种手段，但其整体效果还需要系统评估：系统回顾和荟萃分析护士主导的自我护理干预措施对艾滋病病毒感染者的生活质量、社会支持、抑郁和焦虑的有效性：设计：对随机对照试验进行系统回顾和荟萃分析：方法：对 PubMed、EMBASE、Web of Science（核心收录）、Cochrane Central Register of Controlled Trials、Cumulative Index to Nursing and Allied Health Literature、Scopus 和 PsycINFO (Ovid) 中从开始到 2024 年 5 月的文章进行系统检索。两位作者独立筛选研究并提取数据。纳入的随机对照试验调查了护士指导的自我护理干预措施对 HIV 感染者的生活质量、社会支持、抑郁和焦虑的影响，这些试验均以英文发表。纳入研究的质量采用修订后的 Cochrane 随机试验偏倚风险工具进行评估。使用 Review Manager 5.3 和 Stata17 进行元分析，并使用建议分级评估、发展和评价方法对证据的确定性进行评级：结果：共纳入了 19 项发表于 2003 年至 2024 年的随机对照试验。荟萃分析表明，与对照组相比，护士主导的自我护理干预能显著改善生活质量（SMD = 0.45，95 % CI：0.07 至 0.84，P 结论：护士主导的自我护理干预能显著改善生活质量：护士主导的自我护理干预能有效改善艾滋病病毒感染者的生活质量并减少抑郁，但目前的证据显示这些干预对社会支持的影响甚微。有关焦虑的证据有限，这表明需要进行更严格的研究，以探索这些干预措施对艾滋病病毒感染者焦虑的潜在益处。这些研究结果支持将护士主导的自我护理干预纳入常规艾滋病护理中，以提高艾滋病病毒感染者的幸福感：CRD42024548592。

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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Effectiveness of nurse-led self-care interventions on quality of life, social support, depression and anxiety among people living with HIV: A systematic review and meta-analysis of randomized controlled trials

Background

People living with HIV often face challenges related to quality of life, mental health, and social support. Nurse-led self-care interventions have been proposed as a means to address these issues, but their overall effectiveness needs systematic evaluation.

Objectives

To systematically review and meta-analyze the effectiveness of nurse-led self-care interventions on quality of life, social support, depression, and anxiety among people living with HIV.

Design

A systematic review and meta-analysis of randomized controlled trials.

Methods

A systematic search of PubMed, EMBASE, Web of Science (Core Collection), Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Scopus, and PsycINFO (Ovid) was conducted for articles from inception to May 2024. Two authors independently screened studies and extracted data. Randomized controlled trials that investigated the effects of nurse-led self-care interventions on the quality of life, social support, depression, and anxiety in people living with HIV, published in English, were included. The quality of the included studies was assessed using the revised Cochrane risk-of-bias tool for randomized trials. Meta-analyses were conducted using Review Manager 5.3 and Stata17, and the certainty of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Results

Nineteen randomized controlled trials published between 2003 and 2024 were included. The meta-analysis showed that compared to the control group, nurse-led self-care interventions significantly improved quality of life (SMD = 0.45, 95 % CI: 0.07 to 0.84, P < 0.05) and reduced depression (SMD = − 0.46, 95 % CI: − 0.75 to − 0.17, P < 0.001; RR = 0.80, 95 % CI: 0.68 to 0.94, P < 0.05). The impact on social support was not statistically significant (SMD = − 0.02, 95 % CI: − 0.25 to 0.22, P = 0.89). Only two studies reported beneficial effects on anxiety, indicating a need for further high-quality research.

Conclusion

Nurse-led self-care interventions effectively improve the quality of life and reduce depression in people living with HIV, but current evidence shows these interventions have little impact on social support. The evidence regarding anxiety is limited, indicating a need for more rigorous research to explore the potential benefits of these interventions for anxiety in people living with HIV. These findings support the inclusion of nurse-led self-care interventions in routine HIV care to enhance the well-being of people living with HIV.

Registration number: (PROSPERO): CRD42024548592.

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来源期刊

International Journal of Nursing Studies 医学-护理

CiteScore

15.00

自引率

2.50%

发文量

181

审稿时长

21 days

期刊介绍： The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).