{"title":"认知行为疗法对痴呆患者疗效的随机对照试验的系统评价和荟萃分析。","authors":"Ita Daryanti Saragih, Herry Susanto, Ice Septriani Saragih, Ping-Jen Chen, Bih-O Lee, Ruth Palan Lopez","doi":"10.1111/jocn.70005","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cognitive Behavioural Therapy (CBT) has demonstrated positive effects on emotional well-being and quality of life in individuals with dementia. Limited evidence constrains the generalisability of these findings.</p><p><strong>Methods: </strong>This review was conducted in accordance with PRISMA guidelines. Randomised controlled trials (RCTs) that implemented CBT and assessed cognitive function, depressive symptoms, anxiety and quality of life in individuals with dementia were included. Seven databases-APA PsycINFO, CINAHL, Cochrane Library, Embase, MEDLINE, PubMed and Web of Science-were searched up to 10 October 2024. The Risk of Bias 2 (RoB-2) tool was used to evaluate the methodological quality of included studies. Pooled standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random-effects models for each outcome.</p><p><strong>Results: </strong>A total of 10 RCTs, involving 1412 individuals with dementia and published between 2011 and 2024, were included in the analysis. CBT was associated with a reduction in anxiety (pooled SMD = -0.94; 95% CI = -1.33 to -0.55; I<sup>2</sup> = 0.00%; p < 0.04). No significant differences were found in cognitive function, depression or quality of life between those receiving CBT and those in the control groups.</p><p><strong>Conclusions: </strong>This study suggests that CBT alleviates anxiety in people with dementia. However, further investigation is required to clarify its effects on cognitive function, depressive symptoms and quality of life. Future research should focus on the development of CBT protocols, alongside the exploration of relevant outcome measures.</p><p><strong>Relevance to clinical practice: </strong>CBT has shown potential in improving emotional well-being and quality of life in individuals with dementia. The findings inform healthcare professionals about its clinical utility and effectiveness in dementia care.</p><p><strong>Patient or public contributions: </strong>The findings suggest that traditional CBT may not fully address the needs of people with dementia, emphasising the importance of incorporating multisensory stimulation and caregiver involvement to enhance therapeutic outcomes.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A Systematic Review and Meta-Analysis of Randomised Controlled Trials on the Effect of Cognitive Behavioural Therapy for People With Dementia.\",\"authors\":\"Ita Daryanti Saragih, Herry Susanto, Ice Septriani Saragih, Ping-Jen Chen, Bih-O Lee, Ruth Palan Lopez\",\"doi\":\"10.1111/jocn.70005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Cognitive Behavioural Therapy (CBT) has demonstrated positive effects on emotional well-being and quality of life in individuals with dementia. Limited evidence constrains the generalisability of these findings.</p><p><strong>Methods: </strong>This review was conducted in accordance with PRISMA guidelines. Randomised controlled trials (RCTs) that implemented CBT and assessed cognitive function, depressive symptoms, anxiety and quality of life in individuals with dementia were included. Seven databases-APA PsycINFO, CINAHL, Cochrane Library, Embase, MEDLINE, PubMed and Web of Science-were searched up to 10 October 2024. The Risk of Bias 2 (RoB-2) tool was used to evaluate the methodological quality of included studies. Pooled standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random-effects models for each outcome.</p><p><strong>Results: </strong>A total of 10 RCTs, involving 1412 individuals with dementia and published between 2011 and 2024, were included in the analysis. 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引用次数: 0
摘要
背景：认知行为疗法（CBT）已被证明对痴呆症患者的情绪健康和生活质量有积极作用。有限的证据限制了这些发现的普遍性。方法：本综述按照PRISMA指南进行。纳入了实施CBT并评估痴呆患者认知功能、抑郁症状、焦虑和生活质量的随机对照试验（RCTs）。截至2024年10月10日，检索了apa PsycINFO、CINAHL、Cochrane Library、Embase、MEDLINE、PubMed和Web of science七个数据库。使用风险偏倚2 （rob2）工具评价纳入研究的方法学质量。使用随机效应模型计算每个结果的95%置信区间（ci）的合并标准化平均差异（SMDs）。结果：共有10项随机对照试验纳入分析，涉及1412名痴呆症患者，发表于2011年至2024年。CBT与焦虑的减少相关(综合SMD = -0.94；95% CI = -1.33 ~ -0.55；i2 = 0.00%；结论：本研究提示CBT可减轻痴呆患者的焦虑。然而，需要进一步的研究来阐明其对认知功能、抑郁症状和生活质量的影响。未来的研究应侧重于CBT协议的发展，以及相关结果测量的探索。与临床实践的相关性：CBT已显示出改善痴呆症患者情绪健康和生活质量的潜力。研究结果告知医疗保健专业人员其在痴呆症护理中的临床效用和有效性。患者或公众的贡献：研究结果表明，传统的CBT可能不能完全满足痴呆症患者的需求，强调了结合多感官刺激和护理人员参与的重要性，以提高治疗效果。
A Systematic Review and Meta-Analysis of Randomised Controlled Trials on the Effect of Cognitive Behavioural Therapy for People With Dementia.
Background: Cognitive Behavioural Therapy (CBT) has demonstrated positive effects on emotional well-being and quality of life in individuals with dementia. Limited evidence constrains the generalisability of these findings.
Methods: This review was conducted in accordance with PRISMA guidelines. Randomised controlled trials (RCTs) that implemented CBT and assessed cognitive function, depressive symptoms, anxiety and quality of life in individuals with dementia were included. Seven databases-APA PsycINFO, CINAHL, Cochrane Library, Embase, MEDLINE, PubMed and Web of Science-were searched up to 10 October 2024. The Risk of Bias 2 (RoB-2) tool was used to evaluate the methodological quality of included studies. Pooled standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random-effects models for each outcome.
Results: A total of 10 RCTs, involving 1412 individuals with dementia and published between 2011 and 2024, were included in the analysis. CBT was associated with a reduction in anxiety (pooled SMD = -0.94; 95% CI = -1.33 to -0.55; I2 = 0.00%; p < 0.04). No significant differences were found in cognitive function, depression or quality of life between those receiving CBT and those in the control groups.
Conclusions: This study suggests that CBT alleviates anxiety in people with dementia. However, further investigation is required to clarify its effects on cognitive function, depressive symptoms and quality of life. Future research should focus on the development of CBT protocols, alongside the exploration of relevant outcome measures.
Relevance to clinical practice: CBT has shown potential in improving emotional well-being and quality of life in individuals with dementia. The findings inform healthcare professionals about its clinical utility and effectiveness in dementia care.
Patient or public contributions: The findings suggest that traditional CBT may not fully address the needs of people with dementia, emphasising the importance of incorporating multisensory stimulation and caregiver involvement to enhance therapeutic outcomes.
期刊介绍：
The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice.
JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice.
We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.
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