非药物干预对肾移植受者睡眠质量影响效果的网状meta分析

李香儒; 刘红霞; 赵颖; 林可可; 张淑萍; 林晓鸿

doi:10.16766/j.cnki.issn.1674-4152.004021

非药物干预对肾移植受者睡眠质量影响效果的网状meta分析

doi: 10.16766/j.cnki.issn.1674-4152.004021

1.
北京中医药大学护理学院，北京 100029
2.
中日友好医院泌尿外科，北京 100029

基金项目:

国家自然科学基金项目 82072553

详细信息

通讯作者:
刘红霞，E-mail：hongxia_t@163.com

中图分类号: R699.2
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- 文章访问数: 7
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- 被引次数: 0
出版历程
- 收稿日期: 2024-10-22
- 网络出版日期: 2025-08-14

The effects of non-pharmacological interventions on sleep quality of kidney transplant recipients: a network meta-analysis

1.
School of Nursing, Beijing University of Chinese Medicine, Beijing 100029, China

摘要

摘要: 目的评估不同非药物干预方式对肾移植受者睡眠质量的干预效果，为护理实践提供非药物干预的循证依据。方法系统检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Embase、Cochrane Library等数据库中关于非药物干预方式对肾移植受者睡眠质量影响的随机对照试验。检索时限为建库至2024年8月。使用RStudio和Review Manager 5.4软件进行网状meta分析。结果最终纳入16项研究，共包括11种干预措施，共1 262例肾移植受者。网状meta分析结果显示，与常规护理组相比，归因训练(SMD=-3.64, 95% CI：-4.34~-2.93)、五音疗法结合穴位按摩(SMD=-3.53, 95% CI：-4.31~-2.75)、优质护理(SMD=-1.95, 95% CI：-2.84~-1.06)、正念认知疗法(SMD=-1.68, 95% CI：-2.35~-1.01)、认知行为疗法(SMD=-1.52, 95% CI：-2.04~-0.99)对肾移植受者的睡眠质量有较好的改善效果。累积排序概率图下面积显示，归因训练是改善肾移植受者睡眠质量的最佳非药物干预方式。结论非药物干预可以改善肾移植受者睡眠质量，建议临床优先选择归因训练等措施改善肾移植受者睡眠质量，同时也可以综合各干预措施特点，构建个性化、综合化的干预方案。
- 肾移植 /
- 睡眠质量 /
- 非药物干预 /
- 网状meta分析
Abstract: Objective To evaluate the effects of different non-pharmacological interventions on sleep quality of kidney transplant recipients, and to provide evidence-based non-drug interventions for nursing practice. Methods Randomized controlled trials on the effects of non-pharmacological interventions on sleep quality of kidney transplant recipients were systematically searched from CNKI, Wanfang database, VIP database, Chinese Biomedical Literature Database, PubMed, Embase, and Cochrane Library. The search time limit was from the establishment of the database to August 2024. Network meta-analysis was performed using RStudio and Review Manager 5.4 software. Results Sixteen studies were ultimately included, including a total of 11 interventions, with a total of 1 262 kidney transplant recipients. Compared with the usual care group, rankings of interventions which showed significant effects on sleep quality of kidney transplant recipients were attribution training (SMD=-3.64, 95% CI: -4.34 to -2.93), tune therapy combined with point massage (SMD=-3.53, 95% CI: -4.31 to -2.75), high-quality care (SMD=-1.95, 95% CI: -2.84 to -1.06), mindfulness-based cognitive therapy (SMD=-1.68, 95% CI: -2.35 to -1.01), cognitive behavioral therapy (SMD=-1.52, 95% CI: -2.04 to -0.99). The area under the cumulative ranking probability map showed that attribution training is the best non-pharmacological intervention to improve the sleep quality of kidney transplant recipients. Conclusion Non-pharmacological interventions can improve the sleep quality of kidney transplant recipients, and it is suggested that clinical measures such as attribution training should be preferred to improve the sleep quality of kidney transplant recipients. And the characteristics of each intervention measure can be integrated to build a personalized and comprehensive intervention plan.
- Kidney transplant /
- Sleep quality /
- Non-pharmacological intervention /
- Network meta-analysis

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图 1 文献筛选流程

Figure 1. Document screening flow chart

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图 2 文献偏倚风险评价

Figure 2. Risk of bias assessment

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图 3 非药物干预对肾移植受者睡眠质量影响效果的网状证据结构图

Figure 3. Network evidence structure map of the effect of non-pharmacological interventions on sleep quality of kidney transplant recipients

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图 4 非药物干预措施与常规护理治疗效果比较的森林图

Figure 4. Forest map of the efficacy of non-pharmacological interventions compared with conventional nursing

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图 5 纳入文献的发表偏倚分析图

Figure 5. Publication bias analysis chart of included studies

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表 1 纳入文献基本特征(n=16)

Table 1. Basic information of included literature(n=16)

纳入文献	发表年份	国家	研究对象人数		干预方法		主要结局指标
纳入文献	发表年份	国家	干预组	对照组	干预组	对照组	主要结局指标
莫诗文^[8]	2024	中国	40	40	五音疗法+穴位按摩	常规护理	中医症状积分
李丽等^[9]	2023	中国	37	36	叙事护理+归因训练	常规护理	匹兹堡睡眠质量指数
樊慧^[10]	2023	中国	50	50	认知行为疗法	常规护理	匹兹堡睡眠质量指数
柴艳美^[11]	2022	中国	42	42	层级全责护理干预	常规护理	匹兹堡睡眠质量指数
左小芳^[12]	2022	中国	48	48	归因训练	常规护理	匹兹堡睡眠质量指数
段志梅^[13]	2020	中国	40	40	优质护理模式	常规护理	匹兹堡睡眠质量指数
郑珊等^[14]	2020	中国	90	90	叙事护理	常规护理	QOL-RT(睡眠质量)
刘芳芳等^[15]	2019	中国	43	43	认知行为疗法	常规护理	匹兹堡睡眠质量指数
韩楹等^[6]	2019	中国	31	31	归因训练	常规护理	匹兹堡睡眠质量指数
王敏^[5]	2019	中国	50	50	认知行为疗法	常规护理	匹兹堡睡眠质量指数
王娜^[16]	2018	中国	42	42	正念认知疗法	常规护理	匹兹堡睡眠质量指数
黄俊^[3]	2018	中国	18	20	认知行为疗法	常规护理	匹兹堡睡眠质量指数
杨士来等^[17]	2017	中国	30	28	认知行为疗法	常规护理	匹兹堡睡眠质量指数
陈萍^[18]	2017	中国	30	30	正念认知疗法	常规护理	匹兹堡睡眠质量指数
SAMAREHFEKRI A等^[19]	2020	伊朗	26	27	足部反射疗法	常规护理	Verran and Snyder-Halpern sleep scale
BURKHALTER H等^[20]	2014	瑞士	14	14	亮光疗法	常规护理	起床时间

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