ObjectivesTo systematically review the efficacy of telephone-delivered cognitive behavioral therapy (CBT) for insomnia. MethodsDatabases including PubMed, EMbase, PsycINFO, The Cochrane Library (Issue 7, 2015), CBM and CNKI were searched from inception to July 2015, to collect randomized controlled trials (RCT) about telephone-delivered CBT for insomnia. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, RevMan 5.2 software was used to performing meta-analysis. ResultsFive RCTs involving 322 patients were included. The results of meta-analysis showed that:Compared with the waiting group, the sleep onset latency was shorter (MD=-30.31, 95% CI -40.41 to -20.22, P<0.00001), the waking after sleep onset was shorter (MD=-15.59, 95% CI -24.09 to -7.09, P=0.0003) and the sleep efficiency was higher (MD=11.02, 95% CI 7.87 to 14.18, P<0.00001) in the telephone-delivered CBT group, but there was no significant difference between the two groups in total sleep time (MD=13.45, 95% CI -37.01 to 63.92, P=0.60). ConclusionCurrent evidence shows, telephone-delivered CBT is effective for insomnia. Due to limited quantity and quality of the included studies, the above conclusion needs to be verified by more large-scale, high quality RCTs.
Objective To systematically evaluate the effects of cognitive behavioral therapy (CBT) on improving depression, anxiety and quality of life in patients with maintenance hemodialysis (MHD). Methods We searched PubMed, EMbase, CENTRAL (Issue 8, 2016), Web of Science, CINAHL, PsycoINFO, CBM, CNKI and WanFang Data from inception to Sep. 1st, 2016, to collect randomized controlled trials (RCTs) which studied the effects of CBT on improving depression, anxiety and quality of life in patients with MHD. Literature screening, data extraction, and the risk of bias assessment of all eligible studies were conducted by two reviewers independently. Then, meta-analysis was conducted using RevMan 5.3 software. Results A total of 14 RCTs involving 1 492 patients were included. The results of meta-analysis showed that CBT could significantly improve the depression (SMD=–0.85, 95%CI –0.96 to –0.74,P<0.000 01), anxiety (SMD=–1.16, 95%CI –1.37 to –0.94,P<0.000 01), and quality of life (SMD=0.88, 95%CI 0.21 to 1.56,P=0.010) of MHD patients after 2 months' intervention; however, these effects were not been found within 2 months' intervention (allP values>0.05). Conclusion CBT is efficacious in improving MHD patients' depression, anxiety and quality of life after 2 months' intervention, while these effects within 2 months are still not certain. Because of the limitation of quantity and quality of included studies, more high-quality studies are needed to confirm the above conclusion.
目的 探讨心理行为干预对痛风患者遵医行为的影响。 方法 2006年1月－2010年9月，选取痛风患者190例，随机分为干预组和对照组，两组均进行遵医行为评价和疾病相关检查；对干预组进行认知行为干预，分析患者存在的痛风饮食治疗的认知误区，有针对性地进行心理行为干预。 结果 干预后，干预组认知行为总分和各单项分均高于对照组（P＜0.05），胆固醇、甘油三酯和体质量指数均低于对照组（P＜0.05）；干预组19例（20.0%）复发，对照组36例（37.9%）复发，两组复发率比较，差异有统计学意义（χ2=7.390，P=0.007）。 结论 行为认知治疗可提高痛风患者的治疗依从性，从而有助于改善尿酸等相关指标。
Objective To construct an intervention program for postoperative fear of falling in elderly patients with hip fracture based on cognitive behavioral theory. Methods Based on cognitive behavioral theory and literature review, an initial draft of intervention plan for postoperative fear of falling in elderly patients with hip fracture was constructed. From January to March 2025, after two rounds of expert consultations and revisions, the final plan was formed. Results A total of 16 experts across the country were invited to participate in two rounds of Delphi expert consultations, covering areas such as orthopedic clinical nursing, orthopedic clinical medicine, nursing education, nursing management, rehabilitation therapy, and psychological therapy. The active participation rates for the two rounds of consultations were 94.12% and 100.00%, respectively. The expert authority coefficients were 0.860 and 0.907, respectively, and the Kendall harmony coefficients were 0.369 and 0.524, respectively. Ultimately, a program composed of 5 primary indicators (fall fear management team, fall fear management goals, fall fear assessment, fall fear intervention measures, and post-intervention effect evaluation), 17 secondary indicators, and 31 tertiary indicators was constructed. Conclusion The intervention program for postoperative fear of falling in elderly patients with hip fracture based on cognitive behavior theory constructed in this study is scientific and operable, which can provide reference and guidance for clinical nursing staff.
Objectives To evaluate the effectiveness of cognitive behavioral therapy (CBT) treating insomnia in patients with breast cancer. Methods Such databases as CENTRAL (April 2011), The Cochrane Library (2005 to November 2011), MEDLINE (1948 to April 2011), EMbase (Junuary 1966 to April 2011), CINAHL (Cumulative Index to Nursing and Allied Health Literature, 1982 to April 2011), CBM (1978 to 2011) and CNKI (1979 to 2011) were searched to collect the randomized controlled trials (RCTs) about CBT treating insomnia in patients with breast cancer. Literature screening, data extraction and methodological quality assessment of the included studies were conducted according to the inclusion and exclusion criteria. Then RevMan 5.0 software was used for meta-analysis. Results A total of 5 RCTs were included. The results of meta-analysis showed that, compared with the control group, the CBT group was higher in the score of subjective sleep efficiency; however, it was lower in the subjective sleep onset latency. There were no significant differences between the two groups in the sleep efficiency, total sleep time, sleep onset latency and wake time after sleep onset measured by hypnocinematograph. Conclusion Cognitive behavioral therapy may improve the subjective sleep efficiency and sleep quality, and shorten the sleep onset latency in patients with breast cancer. However, its effect of improving objective sleep quality is still unverifiable at present. It suggests the following measures should be taken for providing better evidences: increasing sample size, adopting blind methods, confirming allocation concealment, and using unified hypnocinematograph.
Objective To compare the effects of cognitive-behavior therapy (CBT) and domestic paroxetine in the treatment of minor depression. Methods A therapeutic technique model for the treatment of minor depression was established. Sixty-four patients with minor depression meeting DSM-IV criteria were divided into CBT and paroxetine groups with 32 patients respectively, and were treated for six weeks. The Hamilton Depression Scale (HAMD) was used to evaluate the clinical efficacy and relapse/recrudescence rate of the two groups. Side effects of paroxetine were also recorded. Results At the end of 2 weeks, no significant difference was noted in the reduction of the HAMD score between the two groups. At the end of 6 weeks, there was little difference in thHAMD score reduction between the two groups (F=8.3,P= 0). No significant difference was found in the curative effects between the two groups (u=316.5,P=0.06).In the paroxetine group, cure rate was 20.7%, significant improvement rate was 48.3%; In the CBT group, cure rate was 10.0%, significant improvement rate was 36.7%.The relapse/recrudescence rate after six in the paroxetine group was higher than in cognitive-behavior therapy group at 6 months’ follow-up (u=106.5,P=0.04).Conclusion The clinical efficacy of cognitive-behavior therapy for minor depression seems to be similar to that of paroxetine. The established model of CBT can be used in clinical practice.
ObjectiveTo systematically review the efficacy of cognitive behavioral therapy (CBT) for improving mental health and social functions in patients with multiple sclerosis (MS). MethodsWe searched PubMed, EMbase, The Cochrane Library (Issue 4, 2016), CBM and CNKI from inception to May 2016, to collect randomized controlled trials (RCT) about CBT on mental health and social function in patients with MS. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 11 RCTs involving 1 102 patients were included. The results of meta-analysis showed that, the HADS scores (depression: MD=-1.28, 95%CI-2.07 to-0.48, P=0.002; anxiety: MD=-1.52, 95%CI-2.99 to-0.06, P=0.04), BDI scores (MD=-9.11, 95% CI-15.82 to-2.40, P=0.008), HRDS scores (MD=-7.23, 95% CI-13.65 to-0.82, P=0.03), Chalder scores (MD=-4.88, 95% CI-6.61 to-3.16, P < 0.000 01), MFIS scores (MD=-2.98, 95% CI-4.52 to-1.44, P=0.000 2) and GHQ-12 scores (MD=-3.61, 95%CI-5.20 to-2.02, P < 0.000 01) in the CBT group were lower than that in the control group. No significant difference was found in WSAS scores (MD=-1.98, 95%CI-4.88 to 0.93, P=0.18) between two groups. ConclusionCBT may be effective for improving the negative mental experience, fatigue and quality of life in MS. No evidence to support CBT has benefits in social functions. Due to the limited quantity and quality of the included studies, the above conclusion needs to be verified by more high quality studies.