非药物管理对成人择期手术术前焦虑影响的系统评价再评价

目的 对成人择期手术术前焦虑的非药物管理措施进行系统评价的再评价。方法 计算机检索中国知网、维普全文数据库、万方全文数据库、中国生物医学文献数据库以及澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、Cochrane Library、PubMed、Embase、CINAHL、psycINFO数据库中有关成人择期手术术前焦虑的非药物管理的系统评价,检索时限为建库至2021年8月,由2名研究人员独立进行文献筛选、资料提取,分别对纳入的系统评价和结局指标进行质量评价,并进行证据质量评价和分析。结果 共纳入19篇系统评价,评价结果显示,2篇系统评价的方法学质量为低级,17篇系统评价的方法学质量为极低。评价了9项非药物管理措施的证据,结果显示,优化术前环节的管理、应用非药物技术对预防或缓解术前焦虑有积极影响。结论 非药物管理在一定程度上可预防或缓解成人择期手术患者的术前焦虑,但系统评价的方法学质量和证据的质量均较低,临床实践需谨慎采纳相关证据,并进一步开展更规范、严谨的研究。

An overview of systematic reviews on efficacy of nonpharmacological management of preoperative anxiety in adult patients undergoing elective surgery

Objective To overview the systematic reviews on efficacy of non-pharmacological management of preoperative anxiety in adult patients undergoing elective surgery. Methods In August 2021,CNKI,VIP Full-text database,Wanfang Full-text Database,China Biomedical Literature Database and Joanna Briggs Institute,the Cochrane Library,PubMed,Embase,CINAHL,and psycINFO databases were searched to collect systematic reviews or meta-analysis on the efficacy of non-pharmacological management of preoperative anxiety in adult patients undergoing elective surgery. 2 researchers screened systematic reviews and extracted the data independently. AMSTAR 2 scale and GRADE system were used to assess the quality of included systematic reviews. Results A total of 19 systematic reviews were included. The evaluation results showed that the methodological quality of 2 pieces of the literature was low and the methodological quality of 17 was critically low. Evidence for 9 non-pharmaceutical management interventions was evaluated. The results showed that optimization of preoperative management and application of non-pharmaceutical techniques had positive effects on preventing or alleviating preoperative anxiety. However,the grade of evidence quality is not high,and only a piece of evidence is intermediate. Conclusion Non-pharmacological management may relieve preoperative anxiety relatively. However,the methodological quality and evidence quality of the study are low,so it is necessary to use evidence carefully and carry out more standardized and rigorous studies.