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系统评价心理社会干预对改善癌症照顾者生活质量的效果。

A systematic review of psychosocial interventions to improve cancer caregiver quality of life.

机构信息

University of the Sciences, Philadelphia, PA 19104, USA.

出版信息

Psychooncology. 2013 Jun;22(6):1200-7. doi: 10.1002/pon.3118. Epub 2012 Jun 25.

Abstract

OBJECTIVE

To evaluate and estimate the effect of psychosocial interventions on improving the quality of life (QoL) of adult cancer caregivers.

METHODS

We conducted a systematic review of randomized controlled trials among adult cancer caregivers published from 1947 to 2011. Rigorous inclusion criteria included randomization of caregivers, use of control groups, and at least one active psychosocial intervention where caregiver QoL was measured. A pair of raters independently reviewed all abstracts, and studies were assessed for quality using an 11-item PEDro coding scale. Data were extracted, examined, and synthesized using a narrative approach.

RESULTS

Six randomized controlled trials met inclusion criteria out of 1066 identified abstracts. Studies were rejected because of methodological flaws and failure to report a measure of caregiver QoL. A total of 1115 caregivers were included at baseline measurements. Estimated effect sizes for included studies were nil to small ranging from 0.048 to 0.271. Studies with larger effect sizes targeted caregivers' problem-solving and communication skills.

CONCLUSIONS

Interventions targeting problem-solving and communication skills may ease the burdens related to patient care and role changes associated with care while improving caregiver's overall QoL. Further research is needed to establish efficacy of interventions across all stages of the 2cancer caregiving experience, especially focusing on issues of caregiver retention, caregiver relationships to the cancer patient, and individual differences in caregiver experiences with different types of cancer.

摘要

目的

评估和估计心理社会干预对改善成年癌症照顾者生活质量(QoL)的影响。

方法

我们对 1947 年至 2011 年发表的成年癌症照顾者的随机对照试验进行了系统评价。严格的纳入标准包括对照顾者进行随机分组、使用对照组和至少一种积极的心理社会干预,同时测量照顾者的 QoL。一对评估员独立审查了所有摘要,并使用 11 项 PEDro 编码量表评估研究质量。使用叙述方法提取、检查和综合数据。

结果

在 1066 篇已识别的摘要中,有 6 项随机对照试验符合纳入标准。由于方法学缺陷和未能报告照顾者 QoL 的衡量标准,研究被拒绝。共有 1115 名照顾者在基线测量时被纳入。纳入研究的估计效应大小从 0.048 到 0.271 不等,范围从无到小。具有较大效应大小的研究针对照顾者的解决问题和沟通技巧。

结论

针对解决问题和沟通技巧的干预措施可能会减轻与患者护理相关的负担和与护理相关的角色变化,同时提高照顾者的整体 QoL。需要进一步研究以确定干预措施在癌症护理体验的所有阶段的疗效,特别是关注照顾者保留、照顾者与癌症患者的关系以及不同类型癌症的照顾者体验的个体差异等问题。

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