以认知行为和正念为基础的干预措施,以应对晚期癌症患者的痛苦:元分析
Ellen Krueger1, Ekin Secinti1, Jesse C Stewart1
1Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA.
Psycho-oncology
|December 6, 2023
概括
认知行为干预 (CBIs) 和基于正念的干预 (MBIs) 为晚期癌症患者提供了微小的痛苦减轻. 对生活质量 (QoL) 的影响很小,CBI和MBI之间没有显著差异.
科学领域:
- 心理社会瘤学 心理社会瘤学
- 基于证据的心理健康干预措施
- 癌症生存率研究的研究.
背景情况:
- 患有晚期癌症的患者经历了显著的痛苦和生活质量降低 (QoL).
- 各种心理社会干预措施,包括传统的认知行为干预 (CBIs) 和基于正念的干预 (MBI),旨在缓解这些症状.
- 在这一群体中,CBI和MBI的比较疗效需要进行系统的评估.
研究的目的:
- 分析并比较传统CBI和MBI对晚期癌症患者的痛苦和生活质量的影响.
- 确定潜在的调节者,影响这些心理社会干预措施的有效性.
- 综合当前关于CBI和MBIs有效性的证据,以改善患者的治疗结果.
主要方法:
- 在主要数据库 (CINAHL,Embase,PsycINFO,PubMed,Web of Science) 进行系统的文献搜索.
- 包括随机对照试验 (RCT),将CBI或MBI与对照组进行比较.
- 随机效应的元分析使用Hedges的g表示效应大小;元回归来探索调节者.
主要成果:
- 对37个RCT的分析显示,痛苦的减少很小 (g = 0.21),QoL的改善很小 (g = 0.15).
- 传统CBI和MBI之间没有发现影响大小的显著差异.
- 个性化干预显示较大QOL效应与组或二次交付相比;没有发现应急调节者.
结论:
- 传统的CBI和MBI在减少晚期癌症患者的痛苦方面显示出适度的益处,对QOL的影响有限.
- 目前的证据表明,CBI和MBI之间的疗效相似,但强调需要更高质量的试验.
- 需要进一步进行严格的研究,直接比较这些干预措施,并探索影响其有效性的因素.
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