Hersch Jolyn, Juraskova Ilona, Price Melanie, Mullan Barbara
Medical Psychology Research Unit, School of Psychology, University of Sydney, New South Wales, Australia.
Psychooncology. 2009 Aug;18(8):795-810. doi: 10.1002/pon.1443.
Women with gynaecological cancer are at risk of poor quality of life outcomes. Although various psychosocial interventions have been developed to address these concerns, such interventions have not yet been systematically evaluated in this population. The current review provides an up-to-date and comprehensive summary of the evidence regarding the effectiveness of psychosocial interventions in women with gynaecological cancers.
Relevant studies were identified via Medline, CINAHL, and PsycINFO databases (1980 to June 2008), reference lists of articles and reviews, grey literature databases, and consultations with physicians and other experts in the field. Only controlled trials comparing a psychosocial intervention with a control group in a gynaecological cancer population, with at least one quality of life variable as a main outcome, were included in the review. Two authors independently assessed trial quality and extracted data.
Twenty-two studies involving 1926 participants were included. There was substantial variability in study quality and results. Evidence was mixed regarding intervention effects on social and sexual functioning, distress, depression, anxiety, attitude to medical care, self-esteem and body image. Interventions generally did not improve physical or vocational outcomes.
There was limited evidence in support of healing touch, whereas information-based interventions seemed largely unable to provide meaningful benefits. Cognitive-behavioural interventions had some positive effects. Counselling appeared to be the most promising intervention strategy for addressing quality of life concerns for women with gynaecological cancers.
妇科癌症患者面临生活质量不佳的风险。尽管已开发出各种心理社会干预措施来解决这些问题，但此类干预措施尚未在该人群中进行系统评估。本综述提供了关于心理社会干预对妇科癌症女性有效性的最新且全面的证据总结。
通过Medline、CINAHL和PsycINFO数据库（1980年至2008年6月）、文章及综述的参考文献列表、灰色文献数据库以及与该领域医生和其他专家的咨询来确定相关研究。纳入本综述的仅为在妇科癌症人群中比较心理社会干预与对照组的对照试验，且至少有一个生活质量变量作为主要结局。两位作者独立评估试验质量并提取数据。
纳入了22项涉及1926名参与者的研究。研究质量和结果存在很大差异。关于干预对社交和性功能、痛苦、抑郁、焦虑、对医疗护理的态度、自尊和身体形象的影响，证据不一。干预措施通常并未改善身体或职业结局。
支持治疗性触摸的证据有限，而基于信息的干预措施似乎大多无法带来有意义的益处。认知行为干预有一些积极效果。咨询似乎是解决妇科癌症女性生活质量问题最有前景的干预策略。
