目的:系统评价心理增强心脏康复(CR)在改善心血管疾病患者心理和功能结局方面的有效性。
方法:在PubMed中进行了系统搜索,Scopus,科克伦图书馆,Embase,和WebofScience,到2024年1月31日。
方法:两名评审员独立确定了随机临床试验,这些试验评估了心理增强CR在改善心血管疾病患者心理和功能结局方面的有效性。搜索产生了1848个结果。最后,本综述纳入了14项研究(1531名参与者)的数据.
方法:有关心脏康复阶段的信息,干预的持续时间,群体特征,衡量的结果,并提取了作者得出的结论。使用修订的Cochrane随机对照试验偏倚风险工具来评估方法学质量。
结果:汇总结果表明,在维持较低的静息血压方面,心理增强的CR比单独进行特定的心脏训练更有效。平均差为-3.09(95%CI:-5.18至-1.00)。此外,心理增强的CR在改善患者的生活质量方面比单独进行特定的心脏训练更有优势,标准化平均差为0.15(95%CI:0.01至0.31)。抑郁和焦虑水平分析,运动耐受力,和血脂谱在两种治疗条件之间没有显着差异。
结论:心理增强的CR对降低静息血压和改善生活质量具有积极作用。然而,支持性方法在解决健康的心理方面效果有限.
■PROSPEROCRD42022304063。论文的贡献。
OBJECTIVE: To systematically review the effectiveness of psychologically-enhanced cardiac rehabilitation (CR) in improving psychological and functional outcomes in patients with cardiovascular disease.
METHODS: A systematic search was performed in PubMed, Scopus, Cochrane Library, Embase, and Web of Science, up to January 31, 2024.
METHODS: Two reviewers independently identified randomized clinical trials that evaluated the effectiveness of psychologically-enhanced CR in improving psychological and functional outcomes in patients with cardiovascular disease. The search yielded 1848 results. Finally, data from 14 studies (1531 participants) were included in the review.
METHODS: Information regarding cardiac rehabilitation phase, duration of the intervention, group characteristics, measured outcomes, and the conclusions drawn by the authors was extracted. The Revised Cochrane risk-of-bias tool for Randomized Trials was used to evaluate the methodological quality.
RESULTS: Pooled results indicate that psychologically-enhanced CR is more effective than specific cardiac training alone in maintaining lower resting blood pressure, with a mean difference of -3.09 (95% CI: -5.18 to -1.00). Furthermore, psychologically-enhanced CR shows superiority in improving patients\' quality of life compared to specific cardiac training alone, with a standardized mean difference of 0.15 (95% CI: 0.01 to 0.31). Analyses of depression and anxiety level, exercise tolerance, and blood lipid profile did not show significant differences between the two treatment conditions.
CONCLUSIONS: Psychologically-enhanced CR shows a positive effect on reducing resting blood pressure and improving the quality of life. However, the supportive methods were of limited effectiveness in addressing the psychological aspects of health.
UNASSIGNED: PROSPERO CRD42022304063. CONTRIBUTION OF THE PAPER.