不同积极心理干预改善癌症幸存者抑郁效果的网状meta分析

摘要
图/表
参考文献(32)
相关文章 (15)

全文: PDF (1132 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨9种积极心理干预改善癌症幸存者抑郁情绪的效果。方法计算机检索PubMed、Web of Science、中国知网、万方等数据库，搜集积极心理干预改善抑郁的随机对照试验（RCT），检索时限从2000年1月至2021年5月。由两位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用Stata 14.2进行网状meta分析。结果共纳入28个RCTs，网状meta分析结果显示：与对照组比较，感恩干预[MD = -1.25，95%CI（-3.08，-0.58），P ＜ 0.0001]改善癌症幸存者抑郁效果最好，其次为接纳承诺疗法[MD = -2.19，95%CI（-4.24，-0.15），P = 0.002]、正念认知疗法[MD = -2.13，95%CI（-3.19，-0.57），P = 0.021]、积极心理治疗[MD = -1.24，95%CI（-4.24，-1.76），P = 0.022]、人生回顾[MD = -1.77，95%CI（-3.09，-0.44），P = 0.019]、正念减压疗法[MD = -1.87，95%CI（-3.26，-0.48），P = 0.026]、回忆疗法[MD = -0.42，95%CI（-1.09，-0.25），P = 0.047]与对照组比较，差异有统计学意义，希望疗法[MD = -1.09，95%CI（-4.84，2.66），P = 0.215]、意义疗法[MD = -0.00，95%CI（-3.64，2.44），P = 0.608]与对照组比较，差异无统计学意义。不同干预措施的概率图下面积排序分别为感恩干预（73.3%）＞接纳承诺疗法（66.8%）＞人生回顾（62.4%）＞正念认知疗法（59.6%）＞积极心理治疗（53.7%）＞正念减压疗法（52.0%）＞希望疗法（46.1%）＞意义疗法（37.7%）＞回忆疗法（33.6%）＞常规心理护理（14.8%）。感恩干预在短期内改善癌症幸存者抑郁情绪最佳。结论感恩干预、正念减压疗法、正念认知疗法、接纳承诺疗法和积极心理治疗都可能是改善癌症幸存者抑郁情绪的最优疗法，具有推广价值。意义疗法、人生回顾、回忆疗法与希望疗法可能更加适用于姑息治疗患者，应依据患者病情选择合适的心理干预。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	叶金婵1 朱娓2 孔维蕾3 马静1 苏建萍1

关键词 ：积极心理, 癌症幸存者, 抑郁, 网状meta分析

Abstract：

Objective To explore the effect of nine kinds of positive psychological intervention on improving depression in cancer survivors. Methods Randomized controlled trials (RCTs) of positive psychological intervention to improve depression were collected from PubMed, Web of Science, CNKI and Wanfang database during January 2000 to May 2021. After two reviewers independently screened the literature, extracted the data and evaluated the risk of bias in the included studies, a net meta-analysis was performed using Stata 14.2. Results A total of 28 RCTs were included, the results of mesh meta-analysis showed that: compared with the control group, gratitude intervention (MD = -1.25, 95%CI [-3.08, -0.58], P < 0.001) had the best effect on depression in cancer survivors, followed by acceptance and commitment therapy [MD = -2.19, 95%CI (-4.24, -0.15), P = 0.002], mindfulness based cognitive therapy [MD = -2.13, 95%CI (-3.19, -0.57), P = 0.021], positive psychological therapy [MD = -1.24, 95%CI (-4.24, -1.76), P = 0.022], life review [MD = -1.77, 95%CI (-3.09, -0.44), P = 0.019], mindfulness based stress reduction [MD = -1.87, 95%CI (-3.26, -0.48), P = 0.026], reminiscence therapy [MD = -0.42, 95%CI (-1.09, -0.25), P = 0.047) compared with the control group, hope therapy [MD = -1.09, 95%CI (-4.84, 2.66), P = 0.215], meaning making intervention [MD = -0.00, 95%CI (-3.64, 2.44), P = 0.608] and there was no significant difference compared with the control group; the order of surface under the cumulative ranking for different interventions were gratitude intervention (73.3%) ＞ acceptance and commitment therapy (66.8%) ＞ life review (62.4%) ＞ mindfulness based cognitive therapy (59.6%) ＞ positive psychological therapy (53.7%) ＞ mindfulness based stress reduction (52.0%) ＞ hope therapy (46.1%) ＞ meaning making intervention (37.7%) ＞ reminiscence therapy (33.6%) ＞ routine psychological nursing (14.8%). Gratitude intervention was the best in improving depression in cancer survivors in the short term. Conclusion The evidence suggests that gratitude intervention, mindfulness based stress reduction, cognitive therapy with mindfulness, acceptance commitment therapy and positive psychotherapy may be the best therapy to improve the depression of cancer survivors, which has the value of promotion. Meaning therapy, life review, recall therapy and hope therapy may be more suitable for palliative care patients. Appropriatepsychological intervention should be selected according to the patient’s condition.

Key words： Positive psychology Cancer survivors Depression Net meta-analysis

基金资助:新疆维吾尔自治区自然科学基金项目（2020D01 C154）。

通讯作者: 苏建萍（1972.6-），女，硕士，教授，主任护师，硕士生导师；研究方向：肿瘤护理。

作者简介: 叶金婵（1995.10-），女，新疆医科大学护理学院2019级临床护理学专业在读硕士研究生；研究方向：肿瘤护理。

引用本文:

叶金婵1 朱娓2 孔维蕾3 马静1 苏建萍1. 不同积极心理干预改善癌症幸存者抑郁效果的网状meta分析[J]. 中国医药导报, 2022, 19(16): 165-169.
YE Jinchan1 ZHU Wei2 KONG Weilei3 MA Jing1 SU Jianping1. Effects of different positive psychological interventions on improving depression in cancer survivors：net meta-analysis. 中国医药导报, 2022, 19(16): 165-169.

链接本文:

https://www.yiyaodaobao.com.cn/CN/ 或 https://www.yiyaodaobao.com.cn/CN/Y2022/V19/I16/165

[1] Yi JC，Syrjala KL. Anxiety and Depression in Cancer Survivors [J]. Med Clin North Am，2017，101（6）：1099-1113.
[2] 陆丽君，王朋朋，刘媛航.癌症抑郁共病患者生化指标的研究进展[J].中西医结合护理（中英文），2020，6（7）：281-284.
[3] Punithavathi VP，Alexander G. PREVALENCE AND PREDICTORS OF ANXIETY，DEPRESSION & SUICIDE AMONG CERVICAL CANCER SURVIVORS IN A TERTIARY CARE CENTER IN TAMIL NADU：A CROSS SECTIONAL STUDY [J]. Journal of Evidence Based Medicine and Healthcare，2019，6（26）：1797-1802.
[4] Layous K，Chancellor J，Lyubomirsky S，et al. Delivering happiness：translating positive psychology intervention research for treating major and minor depressive disorders [J]. J Altern Complement Med，2011，17（8）：675-683.
[5] Francisco R，Luis AB. Extensional properties of macromolecules [J]. Current Opinion in Food Science，2016，9.
[6] Seligman ME，Steen TA，Park N，et al. Positive psychology progress：empirical validation of interventions [J]. Am Psychol，2005，60（5）：410-421.
[7] Heckendorf H，Lehr D，Ebert DD，et al. Efficacy of an internet and app-based gratitude intervention in reducing repetitive negative thinking and mechanisms of change in the intervention’s effect on anxiety and depression：Results from a randomized controlled trial [J]. Behav Res Ther，2019，119：103415.
[8] O’Leary K，Dockray S. The effects of two novel gratitude and mindfulness interventions on well-being [J]. J Altern Complement Med，2015，21（4）：243-245.
[9] Ando M，Morita T，Akechi T，et al. Efficacy of short-term life-review interviews on the spiritual well-being of terminally ill cancer patients [J]. J Pain Symptom Manage，2010，39（6）：993-1002.
[10] Samuel LJ，Szanton SL，Weiss CO，et al. Financial Strain Is Associated with Malnutrition Risk in Community-Dwelling Older Women [J]. Epidemiol Res Int，2012， 2012：696518.
[11] Kwan C，Chan C，Choi KC. The effectiveness of a nurse-led short term life review intervention in enhancing the spiritual and psychological well-being of people receiving palliative care：A mixed method study [J]. Int J Nurs Stud，2019，91：134-143.
[12] Jones C，Lyons C，Cunningham C. Life review following critical illness in young men [J]. Nurs Crit Care，2003，8（6）：256-263.
[13] Westerhof GJ，Bohlmeijer ET，van Beljouw IMJ，et al. Improvement in personal meaning mediates the effects of a life review intervention on depressive symptoms in a randomized controlled trial [J]. The Gerontologist，2010，50（4）.
[14] Ahn SH，An YL，Yoo YS，et al. Effects of a short-term life review on spiritual well-being，depression，and anxiety in terminally ill cancer patients [J]. J Korean Acad Nurs，2012，42（1）：28-35.
[15] van der Spek N，Vos J，van Uden-Kraan CF，et al. Efficacy of meaning-centered group psychotherapy for cancer survivors：a randomized controlled trial [J]. Psychol Med，2017，47（11）：1990-2001.
[16] Berg CJ，Vanderpool RC，Getachew B，et al. A Hope-Based Intervention to Address Disrupted Goal Pursuits and Quality of Life Among Young Adult Cancer Survivors [J]. J Cancer Educ，2020，35（6）：1158-1169.
[17] Sztachanska J，Krejtz I，Nezlek JB. Using a Gratitude Intervention to Improve the Lives of Women With Breast Cancer： A Daily Diary Study [J]. Front Psychol，2019， 10：1365.
[18] Branstrom R，Kvillemo P，Moskowitz JT. A randomized study of the effects of mindfulness training on psychological well-being and symptoms of stress in patients treated for cancer at 6-month follow-up [J]. Int J Behav Med，2012，19（4）：535-542.
[19] Tang YY，Holzel BK，Posner MI. The neuroscience of mindfulness meditation [J]. Nat Rev Neurosci，2015，16（4）：213-225.
[20] Park S，Sato Y，Takita Y，et al. Mindfulness-Based Cognitive Therapy for Psychological Distress，Fear of Cancer Recurrence，Fatigue，Spiritual Well-Being，and Quality of Life in Patients With Breast Cancer-A Randomized Controlled Trial [J]. J Pain Symptom Manage，2020，60（2）：381-389.
[21] Reich RR，Lengacher CA，Alinat CB，et al. Mindfulness-Based Stress Reduction in Post-treatment Breast Cancer Patients：Immediate and Sustained Effects Across Multiple Symptom Clusters [J]. J Pain Symptom Manage，2017， 53（1）：85-95.
[22] Johannsen M，O’Connor M，O’Toole MS，et al. Efficacy of Mindfulness-Based Cognitive Therapy on Late Post-Treatment Pain in Women Treated for Primary Breast Cancer：A Randomized Controlled Trial [J]. J Clin Oncol，2016，34（28）：3390-3399.
[23] Arch JJ，Eifert GH，Davies C，et al. Randomized clinical trial of cognitive behavioral therapy （CBT） versus acceptance and commitment therapy （ACT） for mixed anxiety disorders [J]. J Consult Clin Psychol，2012，80（5）：750-765.
[24] Sonia T，Meriem M，Yacine O，et al. Prevalence of nasopharynx cancer in a Tunisian population [J]. Clin Respir J，2018，12（2）：608-615.
[25] Kinner EM，Armer JS，McGregor BA，et al. Internet-Based Group Intervention for Ovarian Cancer Survivors：Feasibility and Preliminary Results [J]. JMIR Cancer，2018，4（1）：e1.
[26] Liu M，Li Y. Reminiscence therapy-based care program relieves anxiety，depression，and improves quality of life in post-operational non-small cell lung cancer patients [J]. Clin Respir J，2021，15（5）：472-481.
[27] Dong X，Sun G，Zhan J，et al. Telephone-based reminiscence therapy for colorectal cancer patients undergoing postoperative chemotherapy complicated with depression：a three-arm randomised controlled trial [J]. Support Care Cancer，2019，27（8）：2761-2769.
[28] Steinhauser KE，Alexander SC，Byock IR，et al. Do preparation and life completion discussions improve functioning and quality of life in seriously ill patients? Pilot randomized control trial [J]. J Palliat Med，2008，11（9）：1234-1240.
[29] Kenne SE，Martensson LB，Andersson BA，et al. Mindfulness and its efficacy for psychological and biological responses in women with breast cancer [J]. Cancer Med，2017，6（5）：1108-1122.
[30] Lengacher CA，Gruss LF，Kip KE，et al. Mindfulness-based stress reduction for breast cancer survivors （MBSR（BC））：evaluating mediators of psychological and physical outcomes in a large randomized controlled trial [J]. J Behav Med，2021，44（5）：591-604.
[31] Compen F，Bisseling E，Schellekens M，et al. Face-to-Face and Internet-Based Mindfulness-Based Cognitive Therapy Compared With Treatment as Usual in Reducing Psychological Distress in Patients With Cancer：A Multicenter Randomized Controlled Trial [J]. J Clin Oncol，2018，36（23）：2413-2421.
[32] Lesley S，Elizabeth F，Fiona J，et al. Mindfulness-based cognitive group therapy for women with breast and gynecologic cancer：a pilot study to determine effectiveness and feasibility [J]. Supportive Care in Cancer，2013，21（11）.