护理SCI晨读：孕妇压力管理的身心干预：随机对照试验的系统评价和荟萃分析

孕妇压力管理的身心干预：随机对照试验的系统评价和荟萃分析

摘要

目标

量化身心干预对孕妇压力的影响。

设计

对随机对照试验进行了系统的回顾和荟萃分析。

数据源

检索PubMed，Embase，CENTRAL，Web of Science和PsycINFO从建库到2020年1月的相关文献。

审查方法

包括有关孕妇心理压力干预的随机对照试验。使用Cochrane协作“偏倚风险”工具评估方法学质量，并通过RevMan 5.3进行荟萃分析。进行亚组分析和出版偏倚评估。进行事后敏感性分析以调查异质性的来源。

结果

总共纳入28个研究，包括1944名参与者。总体荟萃分析表明，与对照组相比，心身干预组孕妇的产前压力有显著改善（SMD = -0.94； 95％CI [-1.25，-0.63]；p <.00001）。亚组分析的结果表明，包括正念干预，认知行为疗法，放松技术和瑜伽在内的所有类型的身心干预都有助于改善产前压力。团体和个人形式的身心干预都是有效的。4至8周的身心干预似乎是最佳选择。此外，身心干预还可以减少产前焦虑和抑郁。

结论

心身干预是减轻孕妇压力的有前途的方法。但是，由于高度的异质性和发表偏倚，应谨慎解释结果。仍需要进一步的高质量研究来验证发现。

影响力

身心干预已得到广泛实施，以减轻产前压力，但研究结果相互矛盾。这项系统的回顾和荟萃分析表明，身心干预相对安全，方便，可以成功地促进产前压力。这篇综述中提出的建议可能有助于制定科学的身心干预方案，并鼓励在孕妇中应用身心干预，从而有效地控制产前压力。

英文摘要

Aim

To quantify the effect of mind–body interventions on stress in pregnant women.

Design

A systematic review and meta‐analysis of randomized controlled trials wasperformed.

Data Sources

PubMed,Embase, CENTRAL, Web of Science and PsycINFO were searched from each databaseinception to January 2020.

Review methods

Randomized controlled trials regarding mind–body interventions for stress in pregnantwomen were included. Methodological quality was evaluated using the CochraneCollaboration ‘Risk of Bias’ tool and meta‐analysis was performed via RevMan5.3. Subgroup analysis and publication bias assessment were conducted. Post hocsensitivity analysis was performed to investigate the source of heterogeneity.

Results

In total, 28 studies comprising 1944 participants were included. The overall meta‐analysis showed that antenatal stress of pregnant women in the mind–body interventionsgroups showed significant high improvements (SMD=−0.94; 95% CI [−1.25,−0.63];p < .00001) compared with the control groups. Results of subgroup analysesindicated that all types of mind–body interventions including mindfulnessintervention, cognitive behavioural therapy, relaxation techniques and yogawere beneficial to antenatal stress. Both groups and individual formatsmind–body interventions were effective. 4–8 weeks mind–body interventions wereseemed as the optimal choice. Moreover, mind–body interventions wereconcomitant with reducing antenatal anxiety and depression.

Conclusion

Mind–body interventions are promising approaches for stress reduction in pregnant women.Nevertheless, the results should be interpreted with caution because of highheterogeneity and publication bias. Further high‐quality studies are needed toverify the findings.

Impact

Mind–body interventions have been widely implemented to ameliorate antenatal stress, butconflicting results were found across studies. This systematic review andmeta‐analysis suggested that mind–body interventions are relatively safe andconvenient and can successfully promote antenatal stress. The suggestionsproposed in this review may be useful for developing a scientific mind–bodyinterventions regimen and encouraging the application of mind–bodyinterventions in pregnant women, thereby managing antenatal stress effectively.

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