外科瘤患者的外科期心理健康干预:叙事综合和元分析
Joanna Abraham1,2, Katherine J Holzer1, Lavanya Pedamallu1
1Department of Anaesthesiology, Washington University School of Medicine, St Louis, MO, USA.
Anaesthesia
|January 8, 2025
概括
术后的心理健康干预措施有效地减少了癌症手术患者的手术前焦虑和手术后立即抑郁. 然而,这些好处是暂时的,强调了持续干预的必要性.
科学领域:
- 在瘤学瘤学.
- 精神病学是一个精神病学.
- 基于证据的医学基于证据的医学.
背景情况:
- 在接受瘤手术的患者中,焦虑和抑郁的高发病率很普遍.
- 手术前期的心理健康挑战可能会阻碍成功的手术恢复.
研究的目的:
- 评估成年癌症手术患者对焦虑和抑郁症的术前心理健康干预措施的疗效.
- 利用元分析和投票计数方法综合随机对照试验 (RCT) 的发现.
主要方法:
- 进行了在过去5年内发表的RCT的叙事审查和元分析.
- 包括的研究重点是针对接受瘤手术的成年患者的外科手术前心理健康干预.
- 采用随机效应模型进行元分析和对稀疏数据进行投票计数.
主要成果:
- 包括17个RCT,主要来自亚洲,评估心理,药物和针干预措施.
- 在手术前的焦虑 (Hedge's g = -1.03,p = 0.001) 和出院后的抑郁症 (Hedge's g = -0.88,p < 0.001) 显著减少.
- 干预对出院时的焦虑的影响并不显著 (p = 0.08),并且在手术后的持续效益是有限的.
结论:
- 心理和药理干预措施在缓解手术前焦虑和手术后立即抑郁方面表现出有效性.
- 这些干预措施的积极影响似乎不会持续到后期的术后期.
- 未来的研究应该优先考虑开发和测试在外科手术期间提供持续益处的干预措施.
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