Piil K, Juhler M, Jakobsen J, Jarden M
Department of Neurosurgery, The University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark The University Hospitals Center for Health Research (UCSF), Center for Integrated Rehabilitation for Patients with Cancer (CIRE), Copenhagen, Denmark.
Department of Neurosurgery, The University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark Department of Clinical Medicine, Section of Neurology, Psychiatry and Sensory Sciences, The University of Copenhagen, Copenhagen K, Denmark.
BMJ Support Palliat Care. 2016 Mar;6(1):27-34. doi: 10.1136/bmjspcare-2013-000593. Epub 2014 Jun 2.
Patients diagnosed with high-grade gliomas experience a varying and complex symptom burden, and face a high mortality rate. As a consequence, patients with high-grade gliomas and their caregivers have imminent and changing rehabilitative and supportive care needs.
To give a detailed overview of non-pharmacological rehabilitative and supportive care interventions for patients with high-grade gliomas and/or their caregivers, and provide an appraisal of the methodological quality of these studies.
PubMed, Cumulative Index of Nursing and Allied Health Literature and Embase were searched for literature published from 1995 to May 2013. Data from eight studies were reviewed for substantive methods and results. Methodological quality was described and assessed using the scoring system for appraising mixed methods research and concomitantly appraising qualitative, quantitative and mixed methods primary studies in mixed study reviews.
The search yielded 914 unique publications, of which 9 were classified eligible for this review. There is preliminary evidence that cognitive group therapy improves memory skills in patients with high-grade gliomas, early physical training improves functional outcome and massage therapy reduces stress. Patients and caregivers found that telephone follow-up and a specialist nurse function was an effective and useful way to achieve information and support. Finally, psycho-education increased feelings of mastery among caregivers.
As evidence is beginning to emerge, there is a need for well-designed longitudinal and randomised controlled trials of non-pharmacological interventions in high-grade glioma patients and their caregivers in order to develop clinical guidelines for supportive and rehabilitative approaches in this unique population.
被诊断为高级别胶质瘤的患者承受着多样且复杂的症状负担,并且面临着高死亡率。因此,高级别胶质瘤患者及其照护者有着迫切且不断变化的康复和支持性护理需求。
详细概述针对高级别胶质瘤患者及其照护者的非药物康复和支持性护理干预措施,并对这些研究的方法学质量进行评估。
检索了1995年至2013年5月期间发表在PubMed、护理及相关健康文献累积索引和Embase上的文献。对八项研究的数据进行了实质性方法和结果的审查。使用混合方法研究评估评分系统以及在混合研究综述中同时评估定性、定量和混合方法的原始研究,来描述和评估方法学质量。
检索得到914篇独特的出版物,其中9篇被归类为符合本综述的条件。有初步证据表明,认知团体治疗可改善高级别胶质瘤患者的记忆技能,早期体育训练可改善功能结局,按摩疗法可减轻压力。患者和照护者发现,电话随访和专科护士服务是获取信息和支持的有效且有用的方式。最后,心理教育增强了照护者的掌控感。
由于证据开始显现,有必要针对高级别胶质瘤患者及其照护者开展精心设计的非药物干预纵向和随机对照试验,以便为这一特殊人群制定支持性和康复方法的临床指南。