成人冠心病患者焦虑抑郁管理的最佳证据总结

Objective To summarize the best evidence for anxiety and depression management in adults with coronary heart disease (CHD). Methods Evidence regarding anxiety and depression management of adults with CHD was retrieved from the British Medical Journal best practice, UpToDate, Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guideline Network, Registered Nurses Association of Ontario, Cochrane Library, the Joanna Briggs Institute (JBI), PubMed, Embase, Medline, Web of Science, China National Knowledge Infrastructure, and WanFang Data. These publications included guidelines, systematic reviews, expert consensus, and evidence summaries. The data retrieval time was from the establishment of the databases to September 13, 2021. The search terms included coronary heart disease, psychology, anxiety and depression, and the data was sorted on September 14-23, 2021. Two researchers evaluated the quality of the literature and extracted data independently according to both AGREE Ⅱ and the evaluation tools of the JBI evidence‑based healthcare center. The evidence level was graded by using the evidence preliminary classification system and the evidence recommendation level system of the JBI evidence‑based healthcare center. The recommended strength of the evidence was determined with the guidance of JBI′s evidence structure and the discussion within the research group and expert opinions, and then the best evidence for anxiety and depression management in adults with CHD were extracted, summarized and analyzed. Results A total of 22 articleswere included, including 5 clinical guidelines, 14 systematic reviews, 2 expert consensuses and 1 evidence summary. Three articles of the guidelines were graded B with the up‑mentioned recommendtation standard, and the other two were graded A. In the systematic reviews, five articles were rated as grade B, the other nine articles as grade A, and 95% of the items were evaluated as“yes”. The evaluation results of all items in the expert consensuses were“yes”, and the quality grade was A. The evidence summary involved 32 pieces of best evidence regarding five aspects (mental health management mode, risk factor assessment and prevention, psychological problem identification and screening, psychological adjustment and intervention, drug treatment), of which 60% were class 1 evidence, and 34% were recommended with strength A. Conclusions The overall quality of the literature and the level of evidence regarding anxiety and depression management in adults with CHD are high. The key to anxiety and depression management in these patients is innovating the mode of mental health management and implementing effective risk factor assessment and prevention, psychological problem identification and screening, psychological adjustment and intervention, and drug treatment.