认知行为疗法对HIV感染者和AIDS患者抑郁、服药依从性和生活质量影响的系统评价  

Inl uence of Cognitive Behavioural h erapy on Depression, Medication Adherence and Quality of Life in People Living with HIV/AIDS(PLHIV): A Systematic Review

作　　者：傅亮[1,2] 吴密彬[1,2] 胡雁[1,2] 

机构地区：[1]复旦大学护理学院 [2]复旦大学JBI循证护理合作中心,上海200030

出　　处：《中国循证医学杂志》2014年第6期734-742,共9页Chinese Journal of Evidence-based Medicine

基　　金：上海市第三轮公共卫生体系建设三年行动计划项目(编号:GWⅢ-13-11)

摘　　要：目的系统评价认知行为疗法对改善HIV感染者和AIDS患者抑郁,提高服药依从性和生活质量的效果。方法计算机检索h e Cochrane Library(2013年第4期)、Ovid-JBI、PubMed、EMbase、PsycARTICLES、CBM和CNKI数据库,收集关于认知行为疗法对改善HIV感染者和AIDS患者抑郁,提高服药依从性和生活质量的随机对照试验,检索时限均为建库至2013年4月30日。由2名研究者按照纳入与排除标准筛选文献、提取资料并评价质量后,采用RevMan 5.2软件进行Meta分析。结果共纳入17个研究,2 163例患者。Meta分析结果显示,认知行为疗法在6个月内能够改善HIV感染者和AIDS患者的抑郁[SMD=–0.26,95%CI(–0.41,–0.10),P=0.001]和提高患者生活质量[SMD=–0.57,95%CI(–1.04,–0.11),P=0.02],也能提高患者长期服药依从性[WMD=3.98,95%CI(1.67,6.30),P=0.000 8]。结论认知行为疗法对改善HIV感染者和AIDS患者的抑郁和提高生活质量具有较好的短期效果,对提高服药依从性具有长期效果。Objective To systematically evaluate the effects of cognitive behavioural therapy （CBT） on improving depression, medication adherence and quality of life in people living with HIV/AIDS （PLHIV）. Methods We searched The Cochrane Library （Issue 4, 2013）, Ovid-JBI, PubMed, EMbase, PsycARTICLES, CBM and CNKI to collect randomized controlled trials （RCTs） on improving depression, medication adherence and quality of life in PLHIV from the establishment dates to April 30th 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality. Meta-analysis was conducted using RevMan 5.2. Results A total of 17 RCTs were included, involving 2 163 patients, q-he results of meta-analysis showed that CBT significantly improved PLHIV＇s depression （SMD= -0.26, 95%CI -0.41 to -0.10, P=0.001）, and quality of life （SMD= -0.57, 95%CI -1.04 to -0.11, P=0.02） in 6 months. Meanwhile, CBT significantly improved PLHIV＇s medication adherence （WMD=3.98, 95%CI 1.67 to 6.30, P=0.000 8） in the long term. Conclusion CBT is efficacious in improving PLHIV＇s depression and quality of life in the short term, and improving medication adherence in the long term, compared to standard care.

关 键 词：艾滋病 认知行为疗法 抑郁 服药依从性 生活质量 系统评价 Meta分析 随机对照试验 

分 类 号：R473.5[医药卫生—护理学]