Oncological Sciences, Mount Sinai School of Medicine, New York, NY 10029, USA.
Psychooncology. 2013 Aug;22(8):1688-704. doi: 10.1002/pon.3200. Epub 2012 Oct 9.
Quality of life (QOL) is a multidimensional construct that includes physical, psychological, and relationship well-being.
We conducted a systematic review and meta-analysis of randomized controlled studies published between 1980 and 2012 of interventions conducted with both cancer patients and their partners that were aimed at improving QOL. Using bibliographic software and manual review, two independent raters reviewed 752 articles with a systematic process for reconciling disagreement, yielding 23 articles for systematic review and 20 for meta-analysis.
Most studies were conducted in breast and prostate cancer populations. Study participants (N = 2645) were primarily middle aged (mean = 55 years old) and white (84%). For patients, the weighted average effect size (g) across studies was 0.25 (95% CI = 0.12-0.32) for psychological outcomes (17 studies), 0.31 (95% CI = 0.11-0.50) for physical outcomes (12 studies), and 0.28 (95% CI = 0.14-0.43) for relationship outcomes (10 studies). For partners, the weighted average effect size was 0.21 (95% CI = 0.08-0.34) for psychological outcomes (12 studies) and 0.24 (95% CI = 0.6-0.43) for relationship outcomes (7 studies).
Therefore, couple-based interventions had small but beneficial effects in terms of improving multiple aspects of QOL for both patients and their partners. Questions remain regarding when such interventions should be delivered and for how long. Identifying theoretically based mediators and key features that distinguish couple-based from patient-only interventions may help strengthen their effects on patient and partner QOL.
生活质量(QOL)是一个多维结构,包括身体、心理和人际关系的幸福感。
我们对 1980 年至 2012 年间发表的针对癌症患者及其伴侣的干预措施进行了系统回顾和荟萃分析,这些干预措施旨在提高生活质量。使用书目软件和手动审查,两名独立的评估者通过系统的协调分歧过程,审查了 752 篇文章,得出了 23 篇进行系统综述的文章和 20 篇进行荟萃分析的文章。
大多数研究都在乳腺癌和前列腺癌患者群体中进行。研究参与者(N=2645)主要为中老年人(平均年龄=55 岁)和白人(84%)。对于患者,17 项研究的心理结局加权平均效应大小(g)为 0.25(95%CI=0.12-0.32),12 项研究的身体结局为 0.31(95%CI=0.11-0.50),10 项研究的关系结局为 0.28(95%CI=0.14-0.43)。对于伴侣,12 项研究的心理结局加权平均效应大小为 0.21(95%CI=0.08-0.34),7 项研究的关系结局为 0.24(95%CI=0.6-0.43)。
因此,基于夫妻的干预措施在改善患者及其伴侣生活质量的多个方面具有较小但有益的效果。关于何时以及持续多久进行此类干预仍存在疑问。确定基于理论的中介因素和区分夫妻干预与仅患者干预的关键特征,可能有助于增强其对患者和伴侣生活质量的影响。