精神科护士主导的依从性干预对精神分裂症患者临床结局影响的Meta分析  

Effects of psychiatric nurse-led adherence therapy on clinical outcomes and medication adherence in patients with Schizophrenia:a Meta-analysis

作　　者：王正君[1] 周郁秋[1] 杨军[1] 孙玉静[1] 

机构地区：[1]哈尔滨医科大学大庆校区护理学院,大庆市163319

出　　处：《中华护理杂志》2017年第8期958-966,共9页Chinese Journal of Nursing

基　　金：国家自然科学基金面上课题(71673070);哈尔滨医科大学研究生创新科研项目(YJSCX2016-39HYD);哈尔滨医科大学大庆校区校内科研基金项目(DQXN201611)

摘　　要：目的系统评价由精神科护士主导的依从性干预对精神分裂症患者临床结局的效果。方法计算机检索国内外数据库中,关于精神科护士主导的依从性干预对精神分裂症患者服药依从性的随机对照试验。由2名研究员按照纳入和排除标准筛选文献、提取资料、评价质量,采用Rev Man 5.2软件进行Meta分析。结果共纳入15项随机对照试验,试验组683例,对照组681例。结果显示,精神科护士主导的依从性干预能够提高患者的服药依从性态度和依从性行为,改善精神症状、功能和自知力,缩短住院时间。但在降低病耻感、提高生活质量、减轻药物副作用方面,依从性干预效果与对照组相当(P>0.05)。结论由精神科护士主导的依从性干预能有效提高精神分裂症患者的服药依从性,其间接效应包括改善症状、功能和自知力,缩短住院时间,但在降低病耻感、提高生活质量、减轻药物副作用方面并未显示出优势。Objective To systematically evaluate the effects of psychiatric nurse-led adherence therapy on clini- cal outcomes and medication adherence in schizophrenia patients. Methods Searched databases to collect random- ized controlled trials about psychiatric nurse-led adherence therapy for patients with schizophrenia. Two reviewers independently screened literature,extracted data,and assessed the risk of bias of included studies. Then,recta-analy- sis was performed using Rev Man 5.2 software. Results Fifteen studies were recruited,including 683 cases of AT and 681 cases of TAU.The results showed that adherence therapy could improve attitude towards adherence,adher- ence behaviors,psychotic symptoms,function,insight and reduce hospital stay. But regarding stigma,quality of life and side effects,adherence therapy did not show benefits （P〉0.05）. Conclusion Psychiatric nurse-led adherence therapy is effective to improve schizophrenia patients＇ adherence,psychotic symptoms,function,insight and reduce hospital stay.

关 键 词：精神分裂症 服药依从性 干预性研究 META分析 

分 类 号：R473.74[医药卫生—护理学]