Cargando…
Effectiveness and Feasibility of Internet-Based Interventions for Grief After Bereavement: Systematic Review and Meta-analysis
BACKGROUND: Although grief and its symptoms constitute a normal reaction to experiences of loss, some of those affected still report elevated levels of distress after an extended period, often termed complicated grief. Beneficial treatment effects of face-to-face therapies, for example, grief counse...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8701663/ https://www.ncbi.nlm.nih.gov/pubmed/34889769 http://dx.doi.org/10.2196/29661 |
_version_ | 1784621057098907648 |
---|---|
author | Zuelke, Andrea E Luppa, Melanie Löbner, Margrit Pabst, Alexander Schlapke, Christine Stein, Janine Riedel-Heller, Steffi G |
author_facet | Zuelke, Andrea E Luppa, Melanie Löbner, Margrit Pabst, Alexander Schlapke, Christine Stein, Janine Riedel-Heller, Steffi G |
author_sort | Zuelke, Andrea E |
collection | PubMed |
description | BACKGROUND: Although grief and its symptoms constitute a normal reaction to experiences of loss, some of those affected still report elevated levels of distress after an extended period, often termed complicated grief. Beneficial treatment effects of face-to-face therapies, for example, grief counseling or cognitive behavioral therapy against complicated grief, have been reported. Evaluations of internet- and mobile-based interventions targeting symptoms of grief in bereaved individuals with regard to objective quality criteria are currently lacking. OBJECTIVE: We aim to conduct a systematic review and meta-analysis on the effectiveness and feasibility of internet- and mobile-based interventions against symptoms of grief after bereavement. METHODS: We conducted systematic literature searches of randomized controlled trials or feasibility studies published before January 9, 2020, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, in PubMed, PsycINFO, Web of Science Core Collection, and the Cochrane Library. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations system. We further assessed aspects of feasibility and rated quality of interventions using criteria suggested by an expert panel on mental health care (German Association for Psychiatry, Psychotherapy, and Psychosomatics). A random-effects meta-analysis was conducted to assess between-group effect sizes. RESULTS: In total, 9 trials (N=1349) were included. Of these, 7 studies were analyzed meta-analytically. Significant effects were found for symptoms of grief (g=0.54, 95% CI 0.32-0.77), depression (g=0.44, 95% CI 0.20-0.68), and posttraumatic stress (g=0.82, 95% CI 0.63-1.01). Heterogeneity was moderate for grief and depression (I(2)=48.75% and 55.19%, respectively) and low for posttraumatic stress symptoms (I(2)=0%). The overall quality of evidence was graded low (grief and depression) to moderate (posttraumatic stress). User satisfaction with the interventions was high, as was the quality of the interventions assessed using objective quality criteria. CONCLUSIONS: Internet- or mobile-based interventions might constitute an effective treatment approach against symptoms of grief in bereaved adults. However, the small sample sizes and limited number of studies included in the review warrant further investigation. TRIAL REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO) CRD42012002100; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=131428 |
format | Online Article Text |
id | pubmed-8701663 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-87016632022-01-10 Effectiveness and Feasibility of Internet-Based Interventions for Grief After Bereavement: Systematic Review and Meta-analysis Zuelke, Andrea E Luppa, Melanie Löbner, Margrit Pabst, Alexander Schlapke, Christine Stein, Janine Riedel-Heller, Steffi G JMIR Ment Health Review BACKGROUND: Although grief and its symptoms constitute a normal reaction to experiences of loss, some of those affected still report elevated levels of distress after an extended period, often termed complicated grief. Beneficial treatment effects of face-to-face therapies, for example, grief counseling or cognitive behavioral therapy against complicated grief, have been reported. Evaluations of internet- and mobile-based interventions targeting symptoms of grief in bereaved individuals with regard to objective quality criteria are currently lacking. OBJECTIVE: We aim to conduct a systematic review and meta-analysis on the effectiveness and feasibility of internet- and mobile-based interventions against symptoms of grief after bereavement. METHODS: We conducted systematic literature searches of randomized controlled trials or feasibility studies published before January 9, 2020, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, in PubMed, PsycINFO, Web of Science Core Collection, and the Cochrane Library. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations system. We further assessed aspects of feasibility and rated quality of interventions using criteria suggested by an expert panel on mental health care (German Association for Psychiatry, Psychotherapy, and Psychosomatics). A random-effects meta-analysis was conducted to assess between-group effect sizes. RESULTS: In total, 9 trials (N=1349) were included. Of these, 7 studies were analyzed meta-analytically. Significant effects were found for symptoms of grief (g=0.54, 95% CI 0.32-0.77), depression (g=0.44, 95% CI 0.20-0.68), and posttraumatic stress (g=0.82, 95% CI 0.63-1.01). Heterogeneity was moderate for grief and depression (I(2)=48.75% and 55.19%, respectively) and low for posttraumatic stress symptoms (I(2)=0%). The overall quality of evidence was graded low (grief and depression) to moderate (posttraumatic stress). User satisfaction with the interventions was high, as was the quality of the interventions assessed using objective quality criteria. CONCLUSIONS: Internet- or mobile-based interventions might constitute an effective treatment approach against symptoms of grief in bereaved adults. However, the small sample sizes and limited number of studies included in the review warrant further investigation. TRIAL REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO) CRD42012002100; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=131428 JMIR Publications 2021-12-08 /pmc/articles/PMC8701663/ /pubmed/34889769 http://dx.doi.org/10.2196/29661 Text en ©Andrea E Zuelke, Melanie Luppa, Margrit Löbner, Alexander Pabst, Christine Schlapke, Janine Stein, Steffi G Riedel-Heller. Originally published in JMIR Mental Health (https://mental.jmir.org), 08.12.2021. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on https://mental.jmir.org/, as well as this copyright and license information must be included. |
spellingShingle | Review Zuelke, Andrea E Luppa, Melanie Löbner, Margrit Pabst, Alexander Schlapke, Christine Stein, Janine Riedel-Heller, Steffi G Effectiveness and Feasibility of Internet-Based Interventions for Grief After Bereavement: Systematic Review and Meta-analysis |
title | Effectiveness and Feasibility of Internet-Based Interventions for Grief After Bereavement: Systematic Review and Meta-analysis |
title_full | Effectiveness and Feasibility of Internet-Based Interventions for Grief After Bereavement: Systematic Review and Meta-analysis |
title_fullStr | Effectiveness and Feasibility of Internet-Based Interventions for Grief After Bereavement: Systematic Review and Meta-analysis |
title_full_unstemmed | Effectiveness and Feasibility of Internet-Based Interventions for Grief After Bereavement: Systematic Review and Meta-analysis |
title_short | Effectiveness and Feasibility of Internet-Based Interventions for Grief After Bereavement: Systematic Review and Meta-analysis |
title_sort | effectiveness and feasibility of internet-based interventions for grief after bereavement: systematic review and meta-analysis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8701663/ https://www.ncbi.nlm.nih.gov/pubmed/34889769 http://dx.doi.org/10.2196/29661 |
work_keys_str_mv | AT zuelkeandreae effectivenessandfeasibilityofinternetbasedinterventionsforgriefafterbereavementsystematicreviewandmetaanalysis AT luppamelanie effectivenessandfeasibilityofinternetbasedinterventionsforgriefafterbereavementsystematicreviewandmetaanalysis AT lobnermargrit effectivenessandfeasibilityofinternetbasedinterventionsforgriefafterbereavementsystematicreviewandmetaanalysis AT pabstalexander effectivenessandfeasibilityofinternetbasedinterventionsforgriefafterbereavementsystematicreviewandmetaanalysis AT schlapkechristine effectivenessandfeasibilityofinternetbasedinterventionsforgriefafterbereavementsystematicreviewandmetaanalysis AT steinjanine effectivenessandfeasibilityofinternetbasedinterventionsforgriefafterbereavementsystematicreviewandmetaanalysis AT riedelhellersteffig effectivenessandfeasibilityofinternetbasedinterventionsforgriefafterbereavementsystematicreviewandmetaanalysis |