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The Effect of Psychological Intervention for Pain Reduction in Osteoarthritis Patients : A Meta-analysis

골관절염 환자의 통증 감소를 위한 심리적 중재의 효과 : 메타분석

  • Received : 2019.02.20
  • Accepted : 2019.05.03
  • Published : 2019.05.31

Abstract

This study was conducted to provide for the development of psychological interventions through meta-analysis of the effects of psychological intervention for pain reduction in patients with osteoarthritis. R version 3.5.1 program was used to identify the effectiveness of psychological mediating by December 30, 2018, while the Korean and foreign literature published by PubMed, EMBASE, Ovid-MEDLINE, CINAHL, and Korean databases were searched. As a result, 12 studies with a total of 1,847 participants were analyzed in a total of 1,822 literature. The results showed that the overall effect size of psychological intervention for pain reduction in osteoarthritis patients was small effect -0.31(95% CI: -0.50, -0.11, p<.001). In the moderator analysis, the effect size showed a significant difference depending on the intervention type, intervention duration and the intervention provider. The funnel plot analysis was used to analyze the publication bias, and it was visually asymmetric but not asymmetric after the egger's regression test (bias = -3.24, p = .077). The results of this study suggest a standard of efficacy for psychological interventions to improve pain symptoms, which is a major symptom of osteoarthritis, although the number of studies included in the meta-analysis is low and has provided a clinical basis during intervention and intervention providers.

본 연구는 골관절염 환자의 통증 감소를 위한 심리적 중재의 효과를 메타 분석한 연구로 심리적 중재 개발을 위한 기초자료를 제공하기 위해 수행되었다. 연구방법으로는 PubMed, EMBASE, Ovid-MEDLINE, CINAHL, Korean database에서 2018년 12월 30일까지 발표된 국내 외 문헌을 검색하였고, 심리적 중재의 효과 크기를 파악하기 위해 R version 3.5.1 프로그램을 이용하였다. 그 결과 총 1,822편의 문헌에서 총 1,847명의 참가자를 가진 12편의 연구가 최종 분석되었다. 분석결과로는 골관절염 환자에게 통증 감소를 위한 심리적 중재의 전체 효과크기는 -0.31(95% CI:-0.50, -0.11)로 작은 정도의 유효한 효과를 보였다(p<.001). 조절효과 분석에서는 중재 종류, 중재 기간, 중재 제공자에 따른 효과크기가 유효한 차이를 나타냈다. funnel plot 분석으로 출판오류를 분석하였고, 시각적으로 비대칭이었으나 egger's regression test 후 비대칭이 아님을 확인하였다(bias= -3.24, p=.077). 본 연구의 결과는 메타분석에 포함된 연구의 수가 적기는 하나 골관절염 환자의 주요 증상인 통증 문제를 개선하기 위한 심리적 중재의 표준을 제시하였고 중재 종류, 중재 기간, 중재 제공자에 대한 임상적 근거를 마련하였다.

Keywords

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Fig. 1. Flowchart of study selection.

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Fig. 2. Effect of psychological intervention on osteoarthritis

Table 1. Characteristics of articles analyzed in the study.

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Table 2. Moderator variables

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