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The characteristics, application, and effectiveness of chatbots in improving the mental health of young people have yet to be confirmed through systematic review and meta-analysis.
This systematic review aims to evaluate the effectiveness of chatbot-delivered interventions for improving mental health among young people, identify factors influencing effectiveness, and examine feasibility and acceptability.
To identify eligible interventional studies, we systematically searched 11 databases and search engines covering a publication period of January 2014 to September 2024. Meta-analyses and subgroup analyses were performed on randomized controlled trials to investigate the effectiveness of chatbot-delivered interventions and potential influencing factors. Narrative syntheses were conducted to summarize the feasibility and acceptability of these interventions in all the included studies.
We identified 29 eligible interventional studies, 13 of which were randomized controlled trials. The meta-analysis indicated that chatbot-delivered interventions significantly reduced distress (Hedge's g = −0.28, 95% CI [−0.46, −0.10]), but did not have a significant effect on psychological well-being (Hedge's g = 0.13, 95% CI [−0.16, 0.41]). The observed treatment effects were influenced by factors including sample type, delivery platform, interaction mode, and response generation approach. Overall, this review demonstrates that chatbot-delivered interventions were feasible and acceptable.
This review demonstrated that chatbot-delivered interventions had positive effects on psychological distress among young people. Chatbot-delivered interventions have the potential to supplement existing mental health services provided by multidisciplinary healthcare professionals. Future recommendations include using instant messenger platforms for delivery, enhancing chatbots with multiple communication methods to improve interaction quality, and refining language processing, accuracy, privacy, and security measures.
To clarify the concept of disempowerment in adults with chronic illness.
The Walker and Avant approach to concept analysis was used.
A systematic literature search was performed on 14 February 2024, using the following databases: CINHAL, PubMed, PsycINFO, Sociological Abstracts and ProQuest Dissertations & Theses Global A&I: The Humanities and Social Sciences Collection. Studies examining adults' experience of individual disempowerment stemming from chronic illness were included. Definitions and descriptions of the concept in the included studies were extracted and synthesised into defining attributes, antecedents, and consequences.
Forty-five articles were included. Two defining attributes were identified: (1) diminishing opportunities to take control and (2) clients' dissatisfaction with diminishing control. Antecedents were changes in health status related to chronic illness and expectation mismatch within the client, or between clients and their care partners. The consequence of disempowerment was disengagement in the context of disempowerment.
Disempowerment was found as the state of dissatisfaction with diminishing opportunities to control personal lives, which stems from changes in health status and expectation mismatch and leads to disengagement in the context of disempowerment. Contrary to prior studies, where disempowerment was often considered an outcome of an imbalanced relationship between clients and care partners, the present findings showcased disempowerment as a holistic illness experience, involving changes in health status. The understanding of disempowerment as the dissatisfaction with the situation of diminishing opportunities to take control differentiates this concept from the opposite of empowerment, which is conceptualised as clients' ability to make decisions or manage diseases. Findings further highlight the importance of understanding clients' illness experience comprehensively and providing care in a manner that is matched with clients' abilities, expectations and needs. It is suggested that operationalising the concept based on this understanding is necessary in order to understand correlations between disempowerment, its causes and consequences.
Disempowerment has been applied to describe interruptions in their states of being, perceived role performances, and independence in adults with chronic illness from diverse perspectives in the extant literature, such as the opposite of empowerment, action to take away control over personal lives and a state of diminishing ability to tackle problems. Through clarifying the concept, this article will guide the communication, measurement tool development and response in clinical practice.
No patient or public contribution.
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