目的:本综述旨在确定生殖器疱疹患者的经历,以及哪些干预措施可以改善年轻人和患有原发性或复发性生殖器疱疹的成年人的健康相关生活质量。
背景:生殖器疱疹通常与心理社会挑战有关。然而,越来越多的证据表明,其影响可以通过药理和心理干预来改善。
方法:这篇综述考虑了对社区居住的男性和女性的英语和德语研究,任何种族和地理位置,15岁及以上,患有原发性或复发性生殖器疱疹。该综述的定量部分包括报道病毒对患者健康相关生活质量的影响和/或干预措施在改善其健康相关生活质量方面的功效的研究。研究比较了抗病毒抑制疗法和心理干预与常规护理或安慰剂,或者互相对抗。审查的定性部分包括调查年轻人和患有生殖器疱疹的成年人的看法和经验的研究。
方法:从1980年1月至2020年3月检索了11个数据库。在审查的每个阶段都遵循JBI混合方法系统审查的方法,并采用了融合分离的合成和集成方法。
结果:总共31篇出版物涵盖30项研究被认为适合纳入。研究包括定量(n=27,在28份出版物中),定性(n=1),和混合方法(n=2)设计。关键评估分数是可变的,特别是在随机对照试验和分析性横断面研究中.所有研究均纳入,无论方法学质量如何。定量成分确定了抑郁症,疾病关注,压力,焦虑,隔离,污名,自尊心的降低,自我概念,自信,新诊断为生殖器疱疹和复发患者可能会体验与健康相关的生活质量。还发现生殖器疱疹会对工作或学校产生不利影响,性关系,以及与朋友和家人的关系。在自我催眠和某些心理社会干预后,抑郁症显着减轻。药物治疗后焦虑显著降低,心理社会干预,和催眠。心理社会干预显着改善了情绪,和一个自助模块与咨询显著提高了参与者的满意度亲密关系和他们的自尊。药物治疗显著改善了健康相关的生活质量;然而,不同的积极治疗方案之间没有显著差异.该综述的定性部分导致了两个综合发现的确定:“生殖器疱疹的诊断的披露对患有该病毒的人构成了两难选择”和“生殖器疱疹的诊断对个人具有重大的情感影响。“定量和定性证据的整合揭示了一个共识,即生殖器疱疹的诊断对个体有重大的情感影响,并且披露是有压力的,影响关系,并影响与健康相关的生活质量;然而,对于不同干预措施的疗效缺乏共识.
结论:生殖器疱疹可导致极端情绪,社会,关系,和性困扰,但对于哪些干预措施能最有效地改善与健康相关的生活质量的认识不足.需要更多高质量的研究。
This
review sought to identify the experiences of persons living with genital herpes and what interventions improve the health-related quality of life of young people and adults with primary or recurrent genital herpes.
Genital herpes is commonly associated with psychosocial challenges. However, a growing body of evidence suggests that its impact can be ameliorated through pharmacological and psychosocial interventions.
This
review considered English- and German-language studies of community-dwelling males and females, of any ethnicity and geographical location, aged 15 years and older, who had primary or recurrent genital herpes. The quantitative component of the
review included studies that reported on the virus\' impact on patients\' health-related quality of life and/or the efficacy of interventions in improving their health-related quality of life. Studies compared antiviral suppression therapies and psychological interventions with usual care or placebo, or against one another. The qualitative component of the
review included studies that investigated the perceptions and experiences of young people and adults with genital herpes.
Eleven databases were searched from January 1980 to March 2020. The JBI approach to mixed methods systematic reviews was followed at each stage of the
review, and a convergent segregated approach to synthesis and integration was adopted.
A total of 31 publications covering 30 studies were deemed suitable for inclusion. Studies encompassed quantitative (n = 27, across 28 publications), qualitative (n = 1), and mixed methods (n = 2) designs. Critical appraisal scores were variable, particularly among the randomized controlled trials and the analytical cross-sectional studies. All studies were included regardless of methodological quality. The quantitative components identified that depression, illness concern, stress, anxiety, isolation, stigma, and a lowering of self-esteem, self-concept, self-confidence, and health-related quality of life may be experienced by both those newly diagnosed with genital herpes and those with recurrences. It was also identified that genital herpes can have an adverse effect on work or school, sexual relationships, and relationships with friends and family. Depression was found to significantly decrease after self-hypnosis and certain psychosocial interventions. Anxiety significantly decreased following pharmacological treatment, psychosocial interventions, and hypnosis. Psychosocial interventions significantly improved mood, and a self-help module with counseling significantly improved participants\' satisfaction with intimate relationships and their self-esteem. Pharmacological treatment significantly improved health-related quality of life; however, there were no significant differences between different active treatment regimens. The qualitative component of the review led to the identification of two synthesized findings: \"Disclosure of a diagnosis of genital herpes poses a dilemma for people who have the virus\" and \"A diagnosis of genital herpes has a significant emotional impact for the individual.\"Integration of quantitative and qualitative evidence revealed a consensus that a diagnosis of genital herpes has a significant emotional impact for individuals and that disclosure is stressful, affects relationships, and affects health-related quality of life; however, there is a lack of consensus regarding efficacy of different interventions.
Genital herpes can lead to extreme emotional, social, relational, and sexual distress, but there is insufficient knowledge concerning which interventions best improve health-related quality of life. More high-quality research is required.