上部胃腸がん患者の睡眠のための非薬学的介入: 体系的なレビューとメタ解析
Lijun Li1, Shuman Wang1, Qian Sun2
1School of Psychological Sciences, Monash University, Melbourne, Australia.
Journal of pain and symptom management
|September 4, 2025
まとめ
非薬学的介入 (NPI) は,上部胃腸がん患者の睡眠を改善する見込みを示しています. 心理的,情報,症状管理,感覚に基づく介入が最も効果的であったが,さらなる研究が必要である.
科学分野:
- 腫瘍学
- 睡眠医学
- 証拠 に 基づく 実践
背景:
- 睡眠障害は,上部胃腸癌と診断された患者で一般的です.
- 効果的な証拠に基づいた介入を特定することは この集団における睡眠問題の管理に不可欠です
研究 の 目的:
- 上部胃腸がん患者の睡眠障害に対する非薬理学的介入 (NPI) の有効性を体系的に検討し,メタ分析する.
- どのタイプのNPIが睡眠の質を 最も改善しているかを特定する.
主な方法:
- ランダム化制御試験 (RCT) と準実験試験を含む6つのデータベースの包括的な検索が2025年7月まで行われました.
- ランダム効果モデルがメタ分析に用いられ,治療効果の総合平均差 (SMD) を計算した.
- 研究の質とバイアスのリスクを評価するために,コクランバイアスのリスクツール (RoB 2) とGRADEスコアリングを使用した.
主要な成果:
- 2693人の参加者を含む28の研究が分析され,NPIの全体的な効果サイズが大きいことが明らかになった (SMD=-1. 18).
- 心理,情報,症状管理の介入 (SMD=1. 85) と感覚ベースの介入 (SMD=1. 66) は,統計的に有意な睡眠の改善を示した.
- このメタ解析では,身体活動/リハビリテーションと栄養補助の介入は統計的に有意な睡眠改善をもたらさなかった.
結論:
- NPIは上部胃腸がん患者の睡眠を改善する可能性があるが,異質性とバイアスのリスクは決定的な推奨を制限する.
- 心理的・感覚的介入は 最も有望に見えますが 標準化されたプロトコルによる 高品質の大規模なランダム化試験は 必要です
- 将来の研究は,この患者グループにおける睡眠障害に対する最適な介入策を確立するための堅固な方法論に焦点を当てなければならない.
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