Abstract:
Persistent physical symptoms (PPS) remain a challenge in the healthcare system due to time-constrained consultations, uncertainty and limited specialised care capacity. Self-help interventions may be a cost-effective way to widen the access to treatment. As a foundation for future interventions, we aimed to describe intervention components and their potential effects in self-help interventions for PPS. A systematic literature search was made in PubMed, EMBASE, PsycINFO and CENTRAL. Fifty-one randomised controlled trials were included. Interventions were coded for effect on outcomes (standardised mean difference ≥0.2) related to symptom burden, anxiety, depression, quality of life, healthcare utilisation and sickness absence. The Behaviour Change Technique (BCT) Taxonomy v1 was used to code intervention components. An index of potential was calculated for each BCT within an outcome category. Each BCT was assessed as \'potentially effective\' or \'not effective\' based on a two-sided test for binomial random variables. Sixteen BCTs showed potential effect as treatment components. These BCTs represented the themes: goals and planning, feedback and monitoring, shaping knowledge, natural consequences, comparison of behaviour, associations, repetition and substitution, regulation, antecedents and identity. The results suggest that specific BCTs should be included in new PPS self-help interventions aiming to improve the patients\' physical and mental health.
摘要:
持续的身体症状(PPS)仍然是医疗保健系统中的一个挑战,主要是由于时间有限的协商,不确定性和有限的专业护理能力。自助干预可能是扩大治疗机会的一种具有成本效益的方式。为未来的干预奠定基础,我们旨在描述干预成分及其在PPS自助干预中的潜在作用.在PubMed进行了系统的文献检索,EMBASE,PsycINFO和CENTRAL。纳入51项随机对照试验。干预措施对与症状负担相关的结局(标准化平均差≥0.2)的影响进行编码,焦虑,抑郁症,生活质量,医疗保健利用和疾病缺席。行为改变技术(BCT)分类法v1用于编码干预组件。计算结果类别中每个BCT的潜力指数,根据对二项随机变量的双侧检验,每个BCT被评估为“潜在有效”或“无效”。16个BCT显示出作为治疗成分的潜在作用。这些BCT代表了主题:目标和计划,反馈和监控,塑造知识,自然后果,行为比较,协会,重复和替换,regulation,先例和身份。结果表明,新的PPS自助干预措施应包括特定的BCT,以改善患者的身心健康。